Country Profile>People's Republic of Bangladesh>Statistical Data on Disability Profile

3. Current Situation of Persons with Disabilities

3.1 Definition and Classification
The Ministry of Social Welfare, in association with the National Forum of Organisations Working with the Disabled (NFOWD) initiated draft legislation on disability related issues in 1996. This legislation was formally enacted in April 2001 and is knows as The Disability Welfare Act of 2001. Under the legislation, definitions for persons with disabilities was outlined as follows:
1. Persons with Disabilities are those who:
  1. are physically disabled either congenitally or as a result of disease or being a victim of accident, or due to improper or maltreatment or for any other reasons became physically incapacitated or mentally imbalanced
  2. as a result of such disabled-ness or mental impaired-ness
    1. has become incapacitated, either partially or fully
    2. is unable to lead a normal life
2. Persons with visual impairment are classified as:
  - No vision in any single eye
  - No vision in both eyes
  - Visual acuity not exceeding 6/60 or 20/200 (Snellen) in the better eye even with correcting lenses
  - Limitation of the field of vision subtending an angle of 20 (degrees) or worse
3. Persons with physical disabilities are classified as:
  - Lost either one or both the hands
  - Lost sensation, partly or wholly, of either hand
  - Lost either one or both the feet
  - Lost sensation, partly or wholly, of either or both the feet,
  - Physical deformity and abnormality
  - Permanently lost physical equilibrium owing to neuro-disequilibrium
4. Persons with a hearing impairment are classified as:
  - Loss of hearing capacity in the better ear in the conversation range of frequencies at 40 decibels (hearing unit) or more, or damaged or ineffective hearing abilities
5. Persons with a speech impairment are classified as:
  - Loss of one's capacity to utter/pronounce meaningful vocabulary sounds, or damaged, partly or wholly or dysfunctional
6. Persons with a mental disability are classified as:
  - One's mental development is not at par with his chronological age or whose IQ (Intelligent Quotient) is below the normal range, or
  - Has lost mental balance or is damaged, partly or wholly
7. Persons with multiple disabilities are classified as:
  - People who suffer from more than one type of impairment stated above
3.2 Government Policy and National Plan Towards Persons with Disabilities
The Government was a signatory country of the Asian and Pacific Decade of Disabled Persons and has proclaimed full participation and equality of persons with disabilities. It was therefore, that a national policy for people with disability was adopted in 1995. This policy outlined guidelines and projections for the promotion of services for PWDs including the creation of options for proper facilities while supporting the involvement of PWDs in development initiatives.

Following the 1995 National Policy, the Government has also enacted the following measures to further support PWDs:
- Recognize an annual National Day for Disabled Persons (first Wed of April)
- The Disability Welfare Act 2001
- The creation of The National Foundation for the Development of People with Disabilities
The Disability Welfare Act of 2001 was the first and most significant piece of legislation focused on disability issues. It is broken down into the following main areas of concentration (see Appendix I for the full text of the Act):
- Protection of rights of persons with disabilities
- Equal opportunities for participation in education, training, employment opportunities, tax relief and subsidies
- Exemption of custom duties for persons with disabilities and their families on imported items and assistive devices
- Elimination of architectural/logistical barriers
- Dissemination of information on legislation
- Prohibition of abuse and neglect
Although the legislation itself has been accepted and considered a milestone by the Government, it has been recognized as having various limitations and shortcomings. This is primarily due to resource constraints, lack of job opportunities for PWDs and a host of other problems.
3.3 Government System
The Ministry of Social Welfare

The Ministry of Social Welfare is the main governmental organization that implements programs for the protection, care, education, training and rehabilitation for persons with disabilities. The Department of Social Services and the NFOWD falls under the purview of the Ministry of Social Welfare

The National Coordination Council (NCC)

The National Coordination Council (NCC) was formed under the Chairmanship of the Minister of Social Welfare in 1993 and is under the administrative control and management of the Government of Bangladesh. The NCC is comprised of 52 members with representation from PWDs, NGOs, self-help organizations and related governmental agencies. The NCC works closely with the NFOWD.

The National Forum of Organizations Working with the Disabled

The NFOWD was formally established in 1991 in order to create linkages between strategic agencies and interventions. It is the leading national level coordinating body of NGO agencies working on disability issues in Bangladesh. It currently has 138 member organizations.

The National Council for Women's Development (NCWD) The Council is the highest policy making body for women. Headed by the Prime Minister, the council is comprised of 44 top-level members consisting of Ministers and Secretaries from several Ministries, members of Parliament and public representatives. The Council provides policy guidelines, strengthens commitment for women's advancement and improves inter-ministerial coordination by the promotion of cross sectoral issues requiring the active participation of various ministries.

The main responsibilities of NCWD are as follows:
- To ensure women's participation in socio-economic development work, the council formulates rules and regulations for the development work of different Ministries, divisions and other agencies and coordinates them
- To draft laws and regulations to ensure women's legal rights and development and to prevent oppression against women
- To take measures to preserve women's interests in all areas in which women are active and ensure their participation and advancement.
3.4 Regional Cooperation

The Government has organized several workshops, seminars and conferences in Bangladesh in order to share ideas, concepts knowledge and experiences for strengthening global efforts and follow-up actions. In 1997, Bangladesh organized and hosted the Second South Asian Conference on Community based Rehabilitation in collaboration with NGOs and the government. Additionally, the Government in cooperation with other South Asian Association for Regional Cooperation (SAARC) countries set up a SAARC Voluntary Disability Fund for the promotion of persons with disabilities in the region. Additionally, the Government hosted the 11th Asia-Pacific Regional Leadership Training Seminar in 1993.
3.5 Statistics Data

The WHO estimates that approximately 10% of the world's population suffers from disabilities. In the context of Bangladesh that would translate into approximately 12 million people with disabilities based on the 2001 census. However, based on a sample survey conducted in 1991 indicated the number of PWDs was placed at just over 500,000. It should be noted, however, that the Government, with the aid of NGOs, has acknowledged a higher estimate when including PWDs as defined by the Disability Welfare Act 2001. Estimates by ActionAid Bangladesh cite that approximately 7 million people (8% of the total population) require some form of immediate service due to disability related issues.

In 2000, ActionAid conducted a survey of 1,339 PWDs that encompass some of its ongoing projects in Bangladesh. The survey group consisted of 59.8% male and 40.2% female, while the break-down of ages was 0-10 years old (33%), 11-17 years old (17%) and the remaining 50% was over 18 years old. The largest type of impairment amongst the survey group was physical at 42%, followed by visual and speech and hearing impairments at 20% and 20% respectively. The causes of the impairments were primarily due to diseases at 29% and complications during pregnancy at 21%. Accidents comprised almost 15% of the total causes of impairments.

Out of the total 1,339 participants in the survey, over 95% (1,283) of them received some form of rehabilitation service. Out of the total that received rehabilitation services, 18.7% were included in the educational system. 31.4% were in governmental schools, while 39.4% were enrolled in non-formal primary educational schools. None of the participants in the survey were enrolled in university.

Figure 7

Type of Impairment
ActionAid Survey

Description

Figure 8

Cause of Impairment
ActionAid Survey

Description
3.6 Law and Legislation

The Government enacted the Persons with Disability Welfare Act in 2001 which provided specific legislation for persons with disabilities (see Appendix I for the full text of the legislation). However, it is recognized that the legislation does not cover all the required demands of persons with disabilities. The Government has sought out experts with an intention of revising the legislation to work with a review committee that was formed to redraft the entire legislation with necessary amendments involving expertise from different disability organizations, lawyers and other professionals. Limitations in the law include suitable mechanisms to examine and identify all substantive and procedural laws, such as those covering inheritance, marriage and property as well as criminal and civil procedure codes and policy provisions on various subjects.

Despite the passage of the Disability Welfare Act, the Government has not enacted or amended laws and regulations that cover traffic and industrial/labor laws for promoting health and safely in the workplace in public places, in transport and in the home, as well as set safety standards for equipment used in industry, domestic and personal use, with particular attention to the needs of users with disabilities. Furthermore, the Government has not amended laws relating to copyright and the protections of the rights of persons with disabilities to have access to educational, informational and recreational materials for the transcription, transference, translation and reproduction of all such materials.

The National Board of Revenue, through way of a circular, has exempted duties and taxes on the import of vehicles, assistive devices, health and medical supplies, including all equipment and materials needed to improve the quality of life of persons with disabilities. However, there are currently no tax benefits for persons with disabilities and employers of disabled persons and manufacturers of assistive devices, including exemptions from excise duties.
3.7 Social Services
Due to financial constraints, limited resources and various other issues, Bangladesh currently has no established method for the distribution of a widespread social service system throughout the country. However, the promotion of social security measures for persons with disabilities living in poverty has been raised and discussed at various seminars and Governmental committees. Areas of consideration include subsistence allowances for persons with disabilities and special subsidies at transportation, healthcare.
3.8 Medical Services, Rehabilitation and Assistive Devices

The health care system in Bangladesh, typically does not include medical rehabilitation for PWDs. People with disabilities therefore need to largely depend on traditional healers and NGOs for more special needs. It is therefore, that NGOs provide the vast majority of medical services while trying to improve prevention and promote rehabilitation. The Impact Foundation Bangladesh, is a large NGO in Bangladesh, which launched a Floating Hospital in 1999. The Hospital provides persons with disabilities in remote riverin areas general treatment and special surgical operations.

Due to a lack of financial support, non-availability of technological support, quality raw materials and a lack of skilled personnel there are limited businesses involved in the production of assistive devices for PWDs. Artificial limbs are produced at the Orthopedic Hospital in Bangladesh.

The Government has however, taken steps to exempt the import duties and taxes on these essential items and their raw materials. Officially, custom duties are exempted on the imports of assistive devices as well as components and spare parts. However, it is extremely difficult for both the individual users and importers to clear these from the customs, as the concerned persons are not always properly aware of the law. Special permission from high ranking customs officials is often required to clear these from ports.

In Bangladesh there are no formal training programmes for assistive device professionals. Three NGOs organise training opportunities open to participants from other organisations: the Centre for Disability in Development (CDD), the Centre for Rehabilitation of the Paralysed (CRP) and Interlife Bangladesh.

In August 1998 the Assistive Device Network (ADNet) was formed with a mission to assist and support organisations in their activities of improving the situation of people with disabilities through the use of assistive devices. By November 1998 eight government and NGOs were members of ADNet. These member organisations produce and distribute orthotics and prosthetics, standing and walking devices, special seats, wheelchairs, tricycles, hearing aids, toys, assistive devices for daily activities, protective footwear, tools and equipment for work, simple devices for communication, and Braille books. They can also assist in adaptations of homes and other premises to increase accessibility.

The Bangladesh Protibandhi Kallyan Somity (BPKS) established an Assistive Devices Production Center in 1988. The Center has been producing different types of assistive devices and provides maintenance support. The Center produces various types of wheelchairs, crutches, white canes and calipers and long leg braces. BPKS has also developed innovative varieties of wheelchairs which have received awareness from those PWDs requiring a more mobile and flexible devise.
3.9 Community Based Rehabilitation
A large number of NGOs and some governmental agencies are implementing different programs and projects following the Community-Based Rehabilitation (CBR) approach across the country. The Government organized the Second South Asian Conference on Community-Based Rehabilitation for the Disabled in Dhaka in 1997. The Dhaka Declaration was adopted at the conference highlighting the actions for Government agencies and NGOs of the region to promote the causes of PWDs.

Under the framework of the NCC, district level committees (DCC) have been formed in some of the countries districts with Government and NGO representatives to coordinate a local level program for intervention on disability issues, especially through the CBR approach. Efforts are currently underway to gradually form similar DCCs in all of the 64 administrative districts through out the country.

As many as 65 private organizations and at least 3 governmental departments directly implement rehabilitation programs for PWDs mostly adopting the CBR approach. One such organization is the CDD which works to integrate persons with disabilities into the mainstream using Community Approaches to Handicap and Disability (CAHD), a strategy that implements CBR, focusing on the needs of the community as a whole and by meeting needs through the integration of impairment and disability issues into its development assistance. It trains organizations on capacity building and institutional development, provides training of trainers (TOT) for professional development and prepares preventive and rehabilitative materials.

As an effort to systematically and strategically address the issue of disability and development, CDD developed and embarked on the concept of CAHD, which is a method of implementing CBR. CAHD recognizes impairment, disability and handicap as development issues. It is an interactive process that strives for “Recognition of the existence of disabled people and people with impairments, the inclusion of these people in society and the subsequent provision of services to meet their needs.” CAHD, and the processes necessary to implement it, are designed to be included into the ongoing activities of existing organizations. Using existing organizations to establish CAHD is one of the core strategies of this concept. Implementing the CAHD concept means expanding existing program activities.

CAHD was developed in Bangladesh in 1997 by CDD, with support of Handicap International (HI) France, and Christoffel Blindenmission (CBM) Germany. This process has been duly supported by other international organizations like ActionAid Bangladesh, Save the Children Fund Sweden and Foundation for Children's Welfare Stamps Netherlands, Nippon Foundation Japan and the CBR Development and Training Center Indonesia. The vision of CAHD is to establish activities that will minimize the negative impacts disabilities to create changes in attitudes while countering the existence of or eliminating handicaps. The concept is to reach the vision of CAHD, programs focus on activities that:
- “Change the attitude of people and their organizations to create a more equitable sharing of resources of all people, especially those who are disabled”,
- “Change the social environment and the attitudes of people and their organizations to eliminate the barriers that result in the exclusion of disabled persons”,
- “Reduce the impact of impairment and disability on individuals and families through prevention of impairment and provision of adequate services”
CAHD is comprised of four components on which interventions are directed. Simultaneous activities are essential in all of these four components.
1. SOCIAL COMMUNICATION Awareness and attitudinal
  - Providing knowledge to people and organizations about:
  - Causes of impairment, disability and handicap
  - Roles of family members and organizations, in creating handicap
  - Activities that will prevent impairment, disability and handicap
  - Rehabilitation practices that will minimize the impact of impairment and maximize the personal development of disabled persons
2. INCLUSION AND RIGHTS Inclusion and participation into development and socio-political activities with equal status and rights
  - Providing disabled persons the equal opportunity to access their rights as citizens and to participate in all of the activities in their families and communities enables
  - Disabled persons to improve the quality of their lives.
  - People and their organizations have positive experiences with disabled persons, which will change their attitudes
  - Organizations to include disabled persons in their existing programs to give them equal access to opportunities for education, economic activities, and health services
  - Disabled persons to promote their right to play active roles in social and economic activities in their families and communities
  - National organizations to promote for legislation, policy and regulations for recognition of the rights of disabled persons
3. REHABILITATION Therapeutic Interventions
  
  Providing assistance to people who have impairments and disabled persons that will minimize the functional difficulties that are the result of their impairments and maximize their personal development by:
  - Providing basic rehabilitation service in the community
  - Providing referral and transfer services to meet the special needs of disabled persons
  - Developing linkages and transfer options between basic therapy service delivery in the home and referral services
4. MANAGEMENT An organizational function necessary to make sure that the previous three activities are implemented simultaneously and that these activities are relevant, efficient and effective by:
  - Developing a monitoring, research and evaluation system
  - Capacity building of local partners
  - Including disabled persons, their families and the community in the design and monitoring, research and evaluation process to ensure accountability of the CAHD system
  - Developing and facilitating networks
  - Documenting the development and evaluating the impact of the CAHD system
  - Using monitoring, research, documentation, and evaluation information to facilitate and direct the creation of changes to the CAHD system
  Effectiveness of CAHD requires implementation of intervention activities in the following three sectors:
  - Primary: The micro-level, family situations, where people live out most of their lives,
  - Secondary: The first macro-level where people, as members of organizations, work to provide governance or goods and services, and create social change, in the primary sector, and
  - Tertiary: The second macro-level where people, as members of organizations, work to provide in-direct governance, manufacture goods, provide in-direct services, and create social change in the primary sector.
Implementing CAHD CAHD, and the processes necessary to implement it, are designed to be included into the ongoing activities of existing organizations. Using existing organizations to establish CAHD is one of the core strategies in this concept. Implementing the CAHD concept means expanding existing program activities.

CAHD requires the involvement of many different organizations, from government bodies to small local NGOs. Implementing CAHD requires the fundamental involvement of the following types of organizations:

Initiating Organizations: The organization, usually an international non-government organization (INGO) or a local organization supported by an INGO, that has the interest, technical skills and resources to facilitate the development of CAHD in a particular region or country.

Implementing Organizations: Community development CBR organizations that are actively providing assistance to people in communities

Research Organizations: An organization with the technical skills and capacity to develop monitoring, research and evaluation activities as part of a CAHD program.

Referral Organizations: Organizations that have the capacity to provide professional medical and rehabilitation services to disabled persons.

CAHD Networks: Informal groups of organizations that work together to achieve a common purpose such as the implementation of CAHD.

CAHD Implementation Process CAHD follows the following fundamental steps in implementing CAHD:
- Starting the Development of CAHD by initiating organization
- Situational analysis
- Developing training capacity
- Developing CAHD in implementing organizations
- Implementing social communication
- Including disabled persons in family and social activities
- Including disabled persons and their families in development activities
- Including disabled persons in secondary and tertiary sector organizations
- Providing rehabilitation and referral services
- Developing network in the secondary and tertiary sectors
- Including beneficiaries in the monitoring process
- Establishing reporting and information sharing system
The Centre for Rehabilitation of the Paralyzed is an NGO that offers large-scale rehabilitation programs. CRP was opened in 1979 and it currently operates a hospital with over 100 beds, while providing vocational training, micro-credit and health education to PWDs. It operates CBR programs in 49 thanas with the assistance of the Bangladesh Social Service Department. The objectives of CRP are:
- To provide treatment, rehabilitation and support services focusing on physical, emotional, social, psychological and economic aspects
- To promote the development of skilled personnel in health care and rehabilitation in the country and the region
- To develop sub-centers in different parts of the country to expand the services for disabled people in collaboration with other organizations (NGO's, Government, self help organizations and private sector)
- To organize and promote programs for the prevention of disability
- To develop programs for disabled children, focusing on early identification, therapeutic interventions and education
- To promote advocacy and networking on disability issues focusing on equalization of opportunities for disabled people through the removal of physical and social barriers
- To promote empowerment of disabled people through community based services in collaboration with other organizations and social institutions (NGO's, Government, Self help organizations and private sector)
- To promote empowerment of disabled girls and women, focusing on confidence building, education, Vocational Training and employment
- To raise awareness about disability issues nationally, regionally and internationally
- To conduct research consistent with the vision, mission and overall objectives of CRP
- To promote sports and recreational opportunities for disabled people
- To promote collaboration opportunities nationally, regionally and internationally to share experiences and expertise
Currently CRP has three functioning sub-centres at Gonokbari (Savar), Dhaka City Centre (Mohammadpur) and Gobindapur (Mouvlibazar District). CRP is also constructing a new rehabilitation centre at Mirpur in Dhaka. CRP Savar accommodates both in-patients and out-patients. The majority of patients have suffered disability as a result of accidents.

The Bangladesh Health Professions Institute is a training academy based at CRP Savar, giving training up to BSc (Honors) Degree standard. Physiotherapists, Occupational Therapists, Rehabilitation Nurses, Special Education Teachers and Community Based Rehabilitation Workers are all trained at CRP.
3.10 Independent Living Movement
There are currently no organizations that formally promote or practice Independent Living in Bangladesh. However, there are many vocational and training centers that practice CBR as the predominate approach in the country.
3.11 Public Awareness
The Government has made substantial achievements over the past several years in promoting and encouraging agencies and NGO organizations to focus on public awareness programs for PWDs. The Disability Welfare Act of 2001 highlighted the following areas in order to further promote awareness and the prevention of disabilities:
- Launch media campaigns through mass media channels to create awareness on the causative factors of disabilities and measures to avert occurrence of disabilities
- To motivate and organize social workers and voluntary organizations to participate in disabilities prevention programs
- To extend cooperation on the implementation of immunization programs for preventing disabilities
- To disseminate information on measures to avert accidents causing disabilities
- To disseminate information about pre-natal, per-natal, delivery and post-delivery care of the mother and the child, and in order to prevent disabilities, expecting mothers are provided with necessary assistive devices
- To collect data and conduct research on factors causing disabilities and treatment
- To undertake programs to prevent sound pollution
- To undertake supportive programs to prevent defective vehicles on roads.
The following are a few of the public awareness programs instituted by the Government:
- Observation of disability related days
- Socio-cultural programs
- Flexible access to perform television and radio programs
- Publications of newsletters/bulletins
- Seminars
- Symposiums
Through these programs, public awareness in Bangladesh is increasing which is helping to reduce the superstitious and traditional beliefs related to PWDs through a more grassroots level. Many programs of public awareness usually start at the educational levels in schools. Bangladesh has not however, been able to encourage action by the Ministry of Education and other relevant agencies to initiate a review of all educational and functional literacy materials, in different formats with a view to excluding text that is derogatory towards PWDs nor including illustrations and references that support the inclusion of PWDs in mainstream community life.
3.12 Sports
The Ministry of Social Welfare, in association with NGOs, have organized regular cultural and sporting events for the disabled in order to further promote public awareness of PWDs. Many NGOs independently organize cultural and sports events for persons with disabilities. PWD athletes also participated in international events such as the World Special Olympics in June 2003.

A National Sports Federation was formed to facilitate sporting activities for persons with disabilities. Steps have also been taken by the Government and NGOs to include persons with disabilities in the mainstream sports of the country. These events/activities are only organized particularly in urban areas.

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Biwako Millennium Framework Seven Priority Areas:

3.13 Self-help Organizations of persons with disabilities and related family and parent associations
The Government has established the National Coordination Council which is comprised of representatives from different self-help organizations. The Government is also providing annual financial grants to self-help institutes through the National Foundation for the Development of Disabled Persons. Representatives from self-help organization have also recently formed a national task force on disability. Self-help organizations established and cover all of the four major types of disabilities including physical, visual speech and hearing and intellectual.

The Self-help movement of PWDs has been pioneered by Bangladesh Protibandhi Kallyan Somity (BPKS) as the only cross disability self-help organization of the country since 1985.

BPKS is an NGO, based in Dhaka that organizes PWDs of all categories toward forming their own organization at grassroots levels through self-initiatives to contribute to their own and others' development. At present BPKS has been applying the Persons with Disabilities Self-Initiatives to Development approach. The main theme of this approach is Initiatives of our own which may be considered as the action oriented practical version of the theme of Voices of our own.

From field based experiences and other circumstances, this approach has been emerged as a holistic development approach to ensure rights, participation and actualization of opportunities equally to all. By this effort PWDs at the grassroot levels become self-initiative to contribute to the mainstream development through their involvement in the family, society, national and international affairs. BPKS has provided these and has seen improvement achieved in peoples' socio-economic, political and living status through increasing humanity, reducing barriers by the response and initiative of PWDs. As a result, PWDs of the community come under a systematic and official organizational structure called the Disabled Peoples' Organizations to Development.

BPKS is developing 16 types of training programs, including education support, medical support (including camps and surgery), awareness campaigns, job placement, self-esteem building, and home based therapy.
3.14 Women with Disabilities
The Government does not have specific policies toward women with disabilities. As such, many NGOs provide support programs for women with disabilities. As in many developing countries, women in Bangladesh are discriminated against in favor of men, hindering their full participation in society. Women with disabilities are generally even more vulnerable since they face the doubling effect of discrimination.

Studies conducted by the CSID cite that women with disabilities in ‘over protective' families were usually discouraged from participating in activities where they could learn and practice social skills. CSID also indicated that women with disabilities appear to be at risk for emotional, physical and sexual abuse. The prevalence of abuses of women with disabilities was found to be high at 92%.

3.15 Early Detection, Intervention and Education

Early Detection Traditionally, in Bangladesh, most births takes place at parental homes and in most cases ignore basic health services which may be required. In the majority of cases, when births take place at the parental home, untrained and unregistered traditional birth attendants (TBA) are available to help. Therefore, the Government has initiated large-scale programs to train TBAs including detection of disabilities among new born babies. The Government in conjunction with NGOs have also taken measures to motivate families to go to health centers and hospitals for child birth. On a more limited scale, through the Government and NGOs, mother and child health workers are also receiving training on this issue.

Intervention NGOs are relied on heavily for working towards identifying children with disabilities in communities. Resource teachers of Government Integrated Schools have the responsibility of identifying children with disabilities which primarily includes the visually impaired. The identified children are then facilitated to be included in different educational programs. However, this process does not result in a large volume of children receiving specialized care.

Over the years, NGOs have also been providing training and initiated services for the promotion of early intervention for childhood disabilities. Currently there is a presence of skilled trainers and information materials on these issues. The development organizations that have shown an interest to work on early detection and intervention in childhood disabilities were able to procure such training and information materials to develop the skills of their field workers.

Education The scope of education for children with disabilities in Bangladesh is still very limited. This is due to the lack of institutes enrolling children with disabilities along with the shortage of teachers skilled in educating children with disabilities. Even though many exhibit the willingness to teach children with disabilities, they are often unable due to limited teaching approaches and materials to facilitate effective education for children with disabilities.

There has been very little effort to promote the adaptation of teaching approaches and materials with regard to education of children with disabilities. However, the teachers training programs of the Government's Resource Teachers for integrated schools, the Government Institute of Special Education, The Dhaka University and some NGOs provide training coverage on these issues.

Workshops by the NFOWD in association with the Government and NGOs have been conducted on the inclusion of learners with disabilities into mainstream education. There has also been an emphasis on creating provisions for special education at national and regional levels for the disabled learners who would be unable to study in mainstream education.

Ensuring Education for All The Ministry of Education, has adopted the Jomtien Declaration in 1990 which provided for policies toward “Education for All”. This declaration was supposed to include all children and those with disabilities in its scope. However, the education of the disabled was the primary responsibility of the Ministry of Social Welfare which did not adequately address educational issues of disabled children. It was therefore, in pursuance of the implementation of the legislation and the national disability policy, the Government organized an inter-Ministerial meeting to facilitate disability-concerned issues in each of the concerned Ministries. As a follow-up of the inter-Ministerial meeting, a task force was formed to provide technical input into the national action plan.

There are no concrete initiatives developed for appropriate policies and legislation to change the focus of the educational system from a subject-focused to a learner-centered approach. However, the Department of Primary and Mass Education has completed a study on education of children with disabilities in the country. The findings of the study are expected to contribute in the development of policies and its implementation to facilitate further inclusion on children with disabilities in mainstream education. To assist in the enrollment of children with disabilities, efforts have been taken in the NGO sector to provide training to teachers of education institutes.

The Department of Primary Education (DPE) under the Primary and Mass Education Division (PMED) commissioned a research project in 2002 called Educating Children in Difficult Circumstances: Children with Disabilities (ESTEEM II). The Government has recognized that the Education For All initiative will not be successful unless education of children with disabilities is effectively addressed. The study was conducted to assist the Government in developing and/or reforming policies on the education of disabled children in Bangladesh. It has been recognized that unless the Ministry of Social Welfare takes a proactive role in preparing children with disabilities systematically into the mainstream educational system, effective teaching of children with disabilities will not be reached.

As part of the ESTEEM II research project, a survey was conducted in which data was collected from 360 children with disabilities. According to the survey, 28% stated that they had no problems in enrolling into mainstream schools, however, the vast majority of 72% stated that their parents faced problems enrolling them into educational institutions. Of the respondents for the survey, 56% were male while 44% were females and 66% of them lived in rural areas. 50% of the respondents had a physical disability, while 16% had a hearing or speech impairment.

Figure 9

Age of Respondents

Pie chart: Age of Respondents Description

Source: ESTEEM II Study

Figure 10

Types of Disabilities

Pie chart: Types of Disabilities Description

Source: ESTEEM II Study

It was concluded from the research survey, that only 11% of the total group was receiving education. Table 8 highlights the type of schooling they were enrolled in:

Table 8

ESTEEM II Survey Percentage of Disabilities & Education by Type 2002
Type of Disability	Formal	Non- Formal	Inclusive	Integrated	Special	Total
Physical	68	5	5	18	5	101
Multiple	20	20	20	40	0	100
Intellectual	33	17	0	17	33	100
Visual	0	0	0	25	75	100
Hearing & Speech	50	0	0	50	0	100
Other	0	100	0	0	0	100
Total	48	10	5	23	15	101

Source: CSID, ESTEEM II Survey
Other includes children with cerebral palsy
Note: Source data does not equal 100% due to rounding

Provisions for Appropriate Teaching Aids Due to a lack of appropriate teaching aids, assistive devices and facilities there has been a severe shortage of effective education for the disabled. A few NGOs that have been operating special education centers ensure the provision of these items. The Government also runs 64 integrated schools for the visually impaired, which provide materials in Braille.

Increasing Retention Rates for All Children in Education Although there is no specific policies to assume responsibility for education of children with disabilities, attempts have been made to pursue concerned ministries and departments to facilitate assumption of responsibilities of education learners with disabilities in mainstream educational setups. Inter-ministerial meeting have been organized, hosted jointly by the Ministry of Social Welfare and NFOWD to facilitate issues like the education of children and youths with disabilities.

Very minimum intervention took place on the inclusion of disability issues in the educational curriculum. The Ministry of Education included this issue in its ESTEEM II study to explore possibilities of such inclusions.

The country observes an annual National Day for the Disabled Persons with various themes in order to promote the public awareness of PWDs. In 2001, the theme focused on the Education of Children with Disabilities. Many NGOs are operating as non-formal educational set-ups at the community level. These facilities aid in increasing the overall retention rates.

Special schools operated by NGOs and the integrated schools of the Government provide support mechanisms and systems for the disabled. Teachers are trained, teachers' aides provided and therapeutic services and assistive devices are ensured for children with disabilities.

Initiatives have been taken to develop the capacity of teachers to ensure the effective teaching of children with diverse capabilities, including those with disabilities. At the NGO level, training programs to some extent are there for teachers on teaching association with the Government as well as national and international organizations. The resource teachers of the Government run integrated schools are also provided with training. The Institute of Special Education offers regular courses to teachers on teaching learners with disabilities. The University of Dhaka also has a Department of Special Education that offers Honors and Master Courses on this issue.

Educational Programs for Persons with Hearing Impairments For the hearing impaired, the Government manages 7 schools throughout the country. The Government also established the National Complex for Special Education with a capacity of 1,500 students with assistance from the Norwegian Agency for Development (NORAD). The Social Service Department of Bangladesh has been operating a National Center for Special Education (NCSE) since 1991 in Dhaka which provides education and training programs for persons with mental, visual and hearing disabilities. At present there are 33 Special Schools for persons with hearing impairments.

3.16 Training and Employment

Access to economic opportunities for PWDs is still very limited in Bangladesh. One of the major barriers for employment for PWDs is the negative attitude and lack of knowledge that employees possess on their capacity and potentials. Additionally the lack of practical experiences, vocational skills and training constrains PWDs ability to participate in the mainstream workforce. Although Bangladesh has enacted legislation on disability related issues and formulated the National Disability Policy, the issues of interventions towards promotion of employment have not been properly addressed.

The Government declared a 10% quota for persons with disabilities along with orphans in government jobs. However, this is not adequately practiced in a majority of the recruitments. Therefore, the Government has emphasized on establishing the quota in all possible Government recruitments. A Government administrative order recently issued by the Prime Minister emphasized a specific action plan to promote quota-based employment for persons with disabilities.

The Government, through the Ministry of Social Welfare, operates two vocational training institutes for the persons with disabilities including the Employment Rehabilitation Centre for the Physically Handicapped. Some of the development organizations are running skill development training including, wherever possible, PWDs. Additionally, these centers are physically accessible with essential support equipment, however, they have limited capacity.

Prevention and rehabilitation issues into the training curricula for personnel in the health, education and social development sectors has not been addressed systematically in the country. However, there are instances of interventions where different training programs have partially included disability issues. The Directorate of Social Services under the Ministry of Social Welfare in association with NGOs have initiated training of the Social Services officers throughout the country. A notable number of social services officers have already been trained with the goal of training all in the near future.

The NCSE was established in 1991 to train staff, assess the training and rehabilitation needs of PWDs and to develop aids and methods. The CDD is involved in human resource development for organizations working for the disabled. Its experienced trainers and resource persons provide training and develop materials and training courses on institutional and professional skills for community development organizations.

The CSID conducted a study in 2002 whereby a total of 452 people with disabilities were surveyed to determine how widely marginalized PWDs were in employment. According to the study, 60% were self-employed, while the Government was the source for only 5% of employment.

Additionally, PWDs participate in international events such as the 6th International Abilympics in November 2003. According to the NFOWD, 15 gold medals were won, 6 silver and 2 bronze.
3.17 Access to Built Environment and Public Transportation
The Disability Act of 2001 addresses issues of incorporating barrier-free features into existing and new buildings along with public transportation, however, very few initiatives have been taken. National monuments, a few hospitals, certain governmental offices currently have accessibility options for persons with disabilities. But the Government acknowledges that the numbers are insignificant and inadequate regarding the required demands. A new administrative order followed by a few decisions have been given from the Office of the Prime Minister with the emphasis to initiate immediate action on accessibility options for PWDs.

The National Building Code has incorporated accessibility provisions for persons with disabilities into existing buildings. However, it is realized that adding additional features or making infrastructural modifications is costly and difficult.
3.18 Access to Information and Communication

Initiatives have been taken to develop comprehensive Sign Supported Bangla language, which is in the process of being disseminated. Once completed, this will be followed by organized steps for training people, both for communication and development of interpreters. A sign dictionary was developed by the Bangladesh Deaf Federation and endorsed by the Ministry of Social Welfare.

The Government of Bangladesh operates a national Braille press, through the Social Services Department. However, it has not been very functional and not able to meet the requirements of the country. There are also, in very limited volumes, productions of audio cassette materials for people who have difficult reading. Some NGOs have also initiated computerized Braille printing services, which are also limited in scope.

A few NGOs provide skill training and backup support to people with visual impairments in using specialized computer software to create and have access to different publications and prints. This is extremely limited allowing access to only a handful of students and NGO workers.
3.19 Poverty Alleviation through capacity-building, social security and sustainable livelihood programs

As part of the national policy and legislation enacted on disability issues, the Prime Minister of Bangladesh has issued a government administrative order with specific short and long-term action targets. This includes among other things, an initiation of credit support through scheduled banks with a view to economically empowering persons with disabilities and their families, through facilitating income-generating activates. Pursuant to this order, a few Government Banks have included these interventions in their credit support policies.

The Ministry of Social Welfare operates the second largest micro-credit scheme in the country that provides extending services to persons with disabilities throughout the country.

The Government has organized an inter-ministerial meeting to facilitate disability concerned issues in each of the concerned Ministries. As a follow-up, a Task Force has been formed to provide technical input into the national action plans. Inclusion of disability issues into all concerned policies is expected to be systematically dealt with, through this structure. The revised action plan, which is still in a process of finalization, is covering a wide range of issues focusing on diverse needs of persons with disabilities such as, poverty alleviation, health, housing, transport, human resources development, labor, education, communications, culture, tourism, political activities and disaster management programs.

Governmental and NGO programs which provide collateral free loans have assumed tremendous importance in providing credit to poor women in Bangladesh. A few examples are:
- The Bangladesh Rural Development Board's Women's Program
- The Bangladesh Rural Advancement Committee
- Grameen Bank
- The Association for Social
- Women's Entrepreneurship Development Programme
The objective is to develop women as entrepreneurs by providing them training and credit facilities to establish small scale manufacturing and service units. The project has so far assisted thousands women entrepreneurs to set up independent business enterprises.

The Palli Karma Shahayak Foundation (PKSF) The overall objective of the Palli Karma Sahayak Foundation (PKSF) is to alleviate poverty and to improve the quality of life of the poor by providing them with resources for creation of self-employment. The immediate major objectives of PKSF are to provide loans to micro-credit providers (NGOs and governmental programs) to generate income and employment opportunities for the poor, and to assist in the strengthening of the institutional infrastructure of the Partner Organizations (PO) - any recipient of loans from PKSF, to improve on their operations.

Bangladesh has demonstrated the effectiveness of micro-credit as an instrument for poverty alleviation. PKSF was established in 1990 and its role is to expand the outreach and to assist POs to provide micro-credit on sustainable basis. These operational strategies have distinctive advantages, such as by becoming a lending agency for organizations instead of another micro-credit provider, PKSF can reach the whole country by utilizing local NGOs. This approach has the inherent potential of employment generation programs by utilizing the unused capacities of the existing organizations, and by expanding them and creating new ones. The emphasis on institutional development produces sustainable Partner Organizations.

PKSF has three programs:
- Loan Program implemented through Partner Organizations (POs)
- Institutional Development services for the POs
- Research
As a financial institution or 'central resource pool' it provides loans at a service charge of 3 to 5% per annum depending on the cumulative amount of loan disbursed, and on the size and financial strength of the POs. The institutional development program includes training for staff of POs, developing accounting and financial management system, management information systems, advisory services for improving the quality and financial viability of micro-credit programs. PKSF, from time to time, conducts and sponsors research to evaluate its programs. PKSF finances almost all major NGOs in the country. Currently, it finances through its POs nearly 23% of an estimated 8 million micro-credit borrowers.

Community Mobilization and Capacity-Building: The mobilization of the poor is through the POs as part of delivering micro-credit to them. Some of the POs have other services like education, health, training etc. for the poor which are also delivered through the same groups. These programs are usually financed by funds from the bilateral donors or through participation of government programs.

PKSF supports capacity building of POs in a large scale. The success of micro-credit programs depend on the capacity of POs to deliver the desired financial services. This requires strengthening of the POs, especially of the small and medium-size POs. PKSF enhances the capacity of POs through training, technical assistance and advisory services. The areas of critical importance are management systems, human resources, management information system and financial management. PKSF has developed an accounting manual for uniformity in accounting system, which is the basis for its related training activities. Discussions and training sessions are arranged for the directors of small POs on such issues as development of future plans, expansion of programs, and financial planning and policy. The weak areas of POs are identified during supervision visits from PKSF and steps are suggested for improvement. The areas of improvement achieved through advisory services as identified by the POs are: recovering overdue loans, correcting inadequacies of the credit policies, improvement in accounting systems and management information systems, improvement in credit management systems, monitoring of credit programs, generation of surplus income by successfully expanding credit programs and technical assistance for preparing training modules.