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Livelihood pattern of persons with disabilities in Bangladesh

A look into Dhaka City

©2014 Academic Paper 160 Pages

Summary

Bangladesh is one of the most poverty stricken developing countries in south-east Asia. The country faces immense problems of persons with disabilities, but the main problems are not yet prioritized. According to the World Bank estimates, about 15% of the population in Bangladesh consists of persons with disabilities and the number is increasing day by day. It is evident that persons with disabilities are more likely to experience economic and social disadvantages than those without disability in Bangladesh. This book illustrates the livelihood pattern of those persons with disabilities living in Dhaka City.

Excerpt

Table Of Contents


4
GOB
Government of Bangladesh
ICF
International Classification of Functioning, Disability and Health.
ICIDH International
Classification of Impairments, Disabilities and
Handicaps
ICT
Information
and
Communication Technology
ILO
International
Labor Organization
LCD
Leonard Cheshire Disability
MDG
Millennium Development Goals
MIFs
Micro Finance institutions
NFDDP
National Foundation for the Development of Disabled Persons
NFOWD
National Forum of Organizations Working with the Disabled
NGO
Non Governmental Organization
PSC
Public Service Commission
PWDs
Persons with Disabilities.
RMG
Readymade Garments
SARPV
Social Assistance and Rehabilitation for the Physically Vulnerable.
SME
Small and Medium Enterprise
UN
United
Nations
UNCRPD UN Convention of Rights of Persons With Disabilities
UNICEF
The United Nations Children's Fund
VHSS
Voluntary Health Services Society
WHO
World Health Organization
World Bank An Financial Institution
WRD
The World Report on Disability

5
Acknowledgement
To complete this study, we have received support and cooperation from several
people to whom we are really grateful. We would also like to thank to those
who supported us in different ways giving us information needed for the
research. We are delivering our love and thanks to those persons with
disabilities who gave us their valuable time at the time of our data col-
lection.
Md. Ashraful Alam
and
Sheikh Abir Hossain


7
Preface
Bangladesh is one of the poverty stricken developing countries in south-east
Asia. The country faces problems of persons with disabilities but the main prob-
lems are not yet prioritized. According to the World Bank estimates, about 15%
of the population in Bangladesh is persons with disabilities and the number is
increasing day by day. It is evident that persons with disabilities are more likely
to experience economic and social disadvantages than those without disability
in Bangladesh. The book has illustrated the livelihood pattern of those persons
with disabilities in Dhaka city. A brief summary of the findings of the study is
described below
In the study, we have selected the persons with disabilities of different age
ranging from 9 to 69+. We also collected data from both male and female.
There were 35 male and 30 female selected purposively. Maximum number of
respondents was below 38 of their age. Among them, 38.46% respondents
were under 18 years old, 26.15% respondents were in 19-28 years and 15.38%
respondents were in 29-38 years. The minimum number of respondents was
above 59 years old.
In this study, 53.85% respondents were male and most of them were below 38
years. On the other hand, 46.15% respondents were female and most of them
were also below 38 years. Most of the respondents (47.59%) of this study
were married, among them 26.15% were male and 21.54% were female. In
addition, 44.62% respondents were single and only 7.69% were widow.
In consideration of education level, most of the respondents (47.69%) are illit-
erate. Among them the female are more illiterate. In addition, 29.23% re-
spondents have finished their primary education, 15.38% have secondary edu-
cation and 3.08% have finished higher education. So can be realized that most
of the persons with disabilities are illiterate.

8
In this study, most of the respondents (69.23%) are physically disable which
includes loss of hand, leg and waist disorder. Among them 38.46% respond-
ents are male and 30.77% are female. In addition, 24.62% respondents are vic-
tim of visual disability and 6.15% are victim of speech disability.
In consideration of family type and its headship, most of the respondents live
in joint family and father take the headship of most of the family. In addition,
26.15% respondents live in the nuclear family.
In this study, most of the respondents (about 100%) cannot fulfill their basic
needs. Among them, 27.27% are deprived of cloth, 25% are deprived of food,
22.73% are deprived of housing facility and 25% are deprived of medical care.
So it can be stated that about all respondents are deprived of their various
needs and the female respondents are more victim of such deprivation.
In the study, most of the respondents (49.24%) informed that they don't have
participation in family decision making. Only 30.76% respondents informed
that their opinion is evaluated in case of decision making. In addition, 20% re-
spondents informed that their decision is partially evaluated in the family.
It is observed that most of the respondents (49.23%) have bad relation with
their family members. Among them 23.08% are female and 26.15% are male.
In addition, 40% respondents have good relation and 10.77% respondents
have moderate relation with their family members.
In the study, most of the respondents 74.72% are suffering from economic in-
security, social insecurity, maladjustment and loneliness. 18.10% respondents
are suffering from depression. Among them 57.47% female respondents and
42.53% male respondents undergo such problems.

9
Maximum number of respondents (93.85%) is victim of negligence in the
family and among them 43.08% is female and 50.77% are male. In addition,
6.15% respondents informed that their family members don't neglect them.
In this study, most of the respondents 49.06% are neglected in the family due
to their disability and dependency on others, 23.95% are neglected due to pov-
erty, 11.78% are due to unemployment. Among all of them, 54.75% are fe-
male who are more neglected in the family.
I the study, 61.54% respondents informed that they are suffering from differ-
ent physical illness. Among them 38.85% are female and 27.69% are male.
Those who are suffering from illness, among them 32.5% are suffering from
skin disease, 30% are suffering from diabetics, 12.5% are suffering from heart
disease and others are suffering from various metabolic diseases.
Maximum number of respondents 81.54% are facing problem for their treat-
ment of illness. Among them 60% are facing economic problem, 15.38% are
facing scarcity of specialized doctor problem, 4.62% informed about lack of
medicine and supportive materials and 1.54% informed about lack of proper
organization for them. So it is observed that most of the respondents have to
face economic problems in their treatment of illness.
In the study, maximum number of respondents (69.23%) is involved in beg-
ging and among them 38.46% is female and 30.77% are male. In addition,
7.69% respondents work as a day labor, 9.23% are involved in business,
4.62% are student and 6.15% are not involved in any work. Most of the re-
spondents (47.69%) in the study work 4 to 7 hours in a day and among them
26.15% are female and 21.54% are male. In addition, 30.77% respondents
work 8 to 11 hours and 13.85% work 12-15 hours in a day.

10
In consideration of income and expenditure, it is observed that most of the re-
spondents (30.77%) earn 3000-5000 TK as their monthly income. 24.62% re-
spondents informed that their monthly income is 6000-8000TK. On the other
hand 30.77% respondents informed that their monthly expenditure is 6000-
8000 TK. So it is seen that most of the respondents have to expend more than
their actual income.
In the study, maximum number of respondents (81.54%) doesn't have partici-
pation in social functions and among them 43.08% are female and 38.46% are
male. Only 18.46% respondents informed that they occasionally participate in
social functions and among them, 25% participates in wedding ceremony,
16.67% participate in birthday party and 41.67% participate in different picnic
programs.
In the study, it is observed that most of the respondents are not aware of gov-
ernment programs for PWDs. Only 27.69% respondents informed that they
know about some governments programs for PWDs and among them 37.5%
are aware of disability allowance, 30% are aware of destitute allowance and
25% are aware of rehabilitation centre. On the other hand, most of the re-
spondents (67.69%) are not aware of any NGO's programs. Only 32.31% re-
spondents know about one or two NGO's activities.
In the study, we analyzed the opinions of respondents and it is noticed that
most of the respondents (29.07%) expressed their view that the family should
provide proper care to the PWDs, 27.33% recommended for providing
medical support, 26.16% recommended for providing proper food and 11.63%
recommended for gossiping in spare time. In case of society and state's
responsibility, maximum number of respondents (27.06) recommended for
providing diferent services free of costs. 16.47% recommended for crating
awareness, 24.71% recommended for creating more organizations and 25.88%

11
recommended for providing housing facility. So it is realized that the persons
with disabilities need special support and facilities from the society and the
state.


13
Chapter 1
1.1 Introduction
Every human being expects a healthy life. But sometimes natural and manmade
factors put barrier to their expectations. People are sometimes born with disabil-
ity or get disabled in the later stages of life due to accidents, illnesses or any
other environmental/external causes. These kinds of obstacles make their life
unnatural and difficult. The help of their family members, neighborhood and
state can overcome these difficulties. Otherwise, these hardships move to the
worse to face every kind of deprivation and discrimination in the society. They
are denied many rights enjoyed by the normal people (Nargis, 2003). Like that,
Disability is a universal element in the human condition to which no one is im-
mune. According to some sources, as many as one person in ten in the world
has a disability. Three out of four of those are thought to live in developing
countries. `Disability limits access to education and employment, and leads to
economic and social exclusion. Poor people with disabilities are caught in a vi-
cious cycle of poverty and disability, each being a cause and a consequence of
the other' (DFID, 2000).
People with disabilities are a diverse and heterogeneous group. According to the
United Nations estimates, the Asian and Pacific region has by far the largest
number, some 300 million, of the world's disabled persons. (ESCAP, 1991).
This number is obviously increasing day after day. Hence this phenomenon
cannot be ignored any more. It has indeed become a national and burning issue.
Persons with disabilities are looked as a burden of the society which is a com-
mon phenomena in the third world country. To our great regret they are also ig-
nored by the state itself whereas if they are ever provided with better opportuni-
ties and training they could be easily incorporated in the mainstream society and

14
thus could contribute to development of the state and society (Titumir & Hoss-
ain, February 2005).
A multitude of studies have been shown to demonstrate a significant rate
of disability among individuals living in poverty. Persons with disabilities were
shown by the World Bank to comprise 15 to 20 percent of the poorest individu-
als in developing countries(Elwan.A.,1999). Former World Bank President
James Wolfensohn has stated that this connection reveals a link that should be
broken. He stated, "People with disabilities in developing countries are over-
represented among the poorest people. They have been largely overlooked in
the development agenda so far, but the recent focus on poverty reduction strate-
gies is a unique change to rethink and rewrite that agenda"(The World Bank
Report,2011).The link between disability and development has been further
stressed by Judith Heumann, the World Bank's first advisor for internation-
al disability rights, who indicated that of the 650 million people living with dis-
abilities today eighty percent live in developing countries(The Office of Policy
Planning and Public Diplomacy,2012) .
According to the World Bank, "Persons with disabilities on average as a group
experience worse socioeconomic outcomes than persons without disabilities,
such as less education, worse health outcomes, less employment, and higher
poverty rates"(The World Bank,2012). Researchers have demonstrated that
these reduced outcomes may be attributed to a myriad of institutional barriers
and other factors. Furthermore, the prevalence of disabilities in impoverished
populations has been predicted to follow a cyclical pattern by which those who
live in poverty are more likely to acquire a disability and those who have a dis-
ability are more likely to become impoverished.

15
Bangladesh is one of the most poverty stricken developing countries in south-
east Asia.The population of Bangladesh is 152,518,015 according to the recent
housing and population census 2011 of the Bangladesh bureau of statistics.
There is no accurate data or information on the exact number of population of
persons with disabilities in Bangladesh, but 15% of the population in Bangla-
desh are person with disabilities according to the World Bank estimates.
The Government of Bangladesh is working on the rights of persons with disabil-
ities. However, Bangladesh faces problems of persons with disabilities in the
country, but the main problems are not yet prioritized.
In Bangladesh, the number of people with disability is fifteen to twenty million,
and the number is increasing day by day. Recurrent incidents of road accident
and factory fire are making the situation worse (The Daily Star, April 23, 2013).
According to the World Disability Report, published by the World Health Or-
ganization and the World Bank, in 2011, it is estimated that around twenty mil-
lion people in Bangladesh are living with a disability. It is evident that persons
with disabilities are more likely to experience economic and social disad-
vantages than those without disability. There are many reasons for this, ranging
from the limitations that arise from physical and mental impairment to the disa-
bling impact of discrimination and a wide array of other societal barriers.
As in many other developing countries in Bangladesh, people with disabilities
tend to be neglected and as a result they are inadequately protected or support-
ed. Many 'traditional' views on the subject still prevail, disability has traditional-
ly been the step-child of the government. Many people in the Bangladesh view
disability as a curse and a cause of embarrassment to the family. Many also be-
lieve that disability is infectious and that having a disabled person in the house
will bring on an 'evil wind' after which others will be infected with this condi-
tion. Several studies in Bangladesh(CSID,2002, Sultana,2010) show how disa-

16
bled often live in unfriendly and hostile environments, encounter non coopera-
tion ,ill treatment, neglect and hostility in their families and in communities, in
wider society and in government institutions.
In Bangladesh, there have been only a few systemic interventions to raise
awareness of persons with disabilities at the community.. The PWDs are usually
excluded from existing governmental and non-governmental development pro-
grams. Livelihood, a vastly used term, used to refer a means of managing some-
one's economic life which is livelihood by different socio-economic, cultural,
political and geographical aspects. The livelihood pattern of person with disabil-
ities is very regretful in Bangladesh and there are many challenges for the disa-
ble person. People with Disabilities in Bangladesh are among the most vulnera-
ble and deprived segment of the population. The WHO estimates that there are
morn to many cases their families and communities leave them out of the gen-
eral development process. It is estimated that 10% of the total population of
Bangladesh are disabled. According to the record of the Statistics Bureau of
Bangladesh, 6.04 persons are disabled out of each thousand people (BBS,
2002). According to the WHO record, the number of disabled persons in Bang-
ladesh is about 17 million. Today the ratio of the disabled persons in Bangla-
desh is 52:48. Among them 4 million people are physically handicapped and 3.8
million mentally. The number of blind persons is 3.3 million and other kinds of
disabled persons number 2.5 million (UNICEF, 2005).
The issue of disability is neglected. So the national data on disability is very
scarce and is far from reflecting the reality. There have been no attempts to con-
duct regular national disability prevalence survey by the national statistical
agency, Bangladesh Bureau of Statistics (BBS), Action Aid-Bangladesh and
Social Assistance and Rehabilitation for the Physically Vulnerable (SARPV)
put the percent of PWDs at 8.8% of the total population. Bangladesh Protibandi
Kalayan Samiti records 7.8%, while in another survey Action Aid Bangladesh

17
(1996) records 14.04% people suffered from a form of impairment. On the other
hand, the Government of Bangladesh (GOB) surveys in 1982, 1986 and 1998
estimated a national prevalence rate of disability at 0.64%, 0.5% and 1.60% re-
spectively. The WHO's global estimate predicts approximately 10% of all peo-
ple have a disability of one kind or another. 90% of the persons with disabilities
of working age are unemployed in countries like Bangladesh. The prevalence of
disability in Bangladesh is believed to be high because of overpopulation, ex-
treme poverty, illiteracy, lack of awareness, and above all, lack of medical care
and services.
According to The Centre for Disability in Development (CDD), It is estimated
that 16 million people in Bangladesh are living with a disability, receiving little
or no assistance and excluded from mainstream life.
LCD Bangladesh and The Daily Star have recently organized a roundtable on
"Livelihoods for disabled people: Opportunities and challenges". According
this-In Bangladesh, the number of people with disability is fifteen to twenty
million. The prevalence of disabilities in children below 18 years can be esti-
mated to 6% and for the age group above 18 years the prevalence about 14%
corresponding to 3.4 million children with disabilities and 10.2 million adults
with disabilities.
Limited opportunities are available, accessible and affordable to the people with
disabilities for prevention and cure of disablement, education, training and em-
ployment in Bangladesh. Government or private organization do not yet take the
disabled children of the floating population particularly of the mega city Dhaka
into consideration in their development plans. Disabled people are part of our
society. For a civilized nation there is no chance for denying the right of them.
In order to uphold the rights and dignity of persons with disability, integrate
their full participation in national and social activities ensuring their overall

18
welfare and other relevant issues pertaining to them, the Government of Bang-
ladesh enacted "Bangladesh Disability Act-2001". The Welfare Act of 2001 did
not serve the cause of disability and has been in cold storage for 11 long years.
1.5 million People with disabilities live in extreme poverty but not more than
10% extreme poor disabled come under the poverty alleviation programs. (A
study on mobility problem of disabled people in Dhaka city retrieve from.
The Constitution of Peoples Republic of Bangladesh guarantees and equality in
all respects: political, social, religious, education and employment irrespective
of race, caste, sex, ethnicity and disability. It has numerous provisions that obli-
gate the government to protect the rights and dignity of all citizens of the coun-
try equally without any bias (Articles-10, 11, 15, 17, 19, 20, 21, 27, 29, 31, 32,
36, 38 and 39).
A group of students of Department of Statistics, University of Dhaka conducted
a survey in Dhaka city to collect socio-economic information for identification
of disabled people. Information on disability and how it affected their life was
also obtained either from the disabled people or from their caregivers by inter-
viewing them. The study revealed that disability had a devastating effect on the
quality of life of the disabled people with a particularly negative effect on their
marriage, educational attainment, employment, and emotional state. Disability
also jeopardized their personal, family and social life. More than half of the dis-
abled people were looked at negatively by society.
Considering this perspective, it can be felt that opportunities to be provided to
the disabled in Bangladesh, cannot equal to those which are possible in an ad-
vanced society. In short, this study will be focused on understanding the chal-
lenges and livelihood patterns of the person with disabilities in Dhaka City.

19
1.2 Rationale of the Study
Bangladesh is considered as one of the least developed countries in the world as
measured in terms of average income, calories consumed per person; high infant
mortality rate; and low literacy rates especially among women. The situation of
People with Disabilities (PWDs) in Bangladesh is competitively far below the
average of any section of people. Bangladesh is country of 16 million persons
with disabilities (10% of the total population). In Bangladesh PWDs are exclud-
ed from most governmental and nongovernmental programs. PWDs are neglect-
ed in Bangladesh, as they are in most other developing countries. Current statis-
tics indicate that there are more than 12,000,000 PWDs living in communities
throughout Bangladesh who currently receive little or no assistance; of these
about 6 - 8 % are children. In nearly all the cases their families and communities
leave them out from the general development process. This has resulted in ex-
cluding them from Government and NGO programs. The neglect is compound-
ed by the lack of available services to provide assistance to PWDs so that they
can participate in the main stream development activities.
During the last few years, Disability, as a development issue is gradually gain-
ing some recognition.
Figure: Disability as a Development Issue
(http://unnayan.org/reports/Disability%20Prevalence%20and%20KAP%20Study.pdf).

20
The United Nations declaration of Decade of Disabled Persons 1983-1992 is an
example of that. While evaluating the achievement of world decade activities in
1992 it was observed that, the Asian & the pacific region were far behind to
achieve the target plans, which subsequently led to another decade declaration
for the Asian & the pacific countries. Bangladesh is one of the 20 countries that
ratified the UN Convention of Rights of Persons with Disabilities (UNCRPD) to
enact the convention. Bangladesh also ratified the Optional Protocol. As a sig-
natory country, Bangladesh is committed to achieve the target of agenda for ac-
tion of the said Asian & the Pacific Decade of Disabled Persons, 1993-2002.
The major focus of the agenda of the decade is to enable people with disability
to achieve equal opportunity so that they can participate in nation building ac-
tivities. To harmonize the disability convention, Bangladesh has drafted Rights
of Persons with Disability Act, 2012 (pending) and included disability in the
National Education Policy, 2010, National Child Policy, 2011 and National
Skill Development Policy, 2011. However, these policies are not being properly
implemented. Only 10% school going children with disabilities are enrolled into
schools. Schools buildings are not accessible, children with disabilities are not
welcome for admission into schools, and teachers are not aware how to teach
students. There are10% quota of employment of persons with disabilities in 3rd
and 4th class jobs in the government department but these are hardly followed.
In the National Budget of 2012-2013, only .5% of the total social protection is
allocated for people with disabilities, who are 10% of the total population
(http://add.org.bd/our-programmes/promoting-economic-and-social-rights-and-
electoral-rights-of-persons-with-disabilities-in-bangladesh).
It can be mentioned that many organizations, both government and NGOs, are
now considering the inclusion of disability components in their programs. How-
ever, it is noteworthy that disability issues are not very much familiar to most of
the development planners and the implementers, which result in acting as a bar-

21
rier for taking up disability programs by the organization. Even the disability
organizations do not have adequate information and documents to update their
programs and activities to reach the desired level. The reasons for such limita-
tion have been identified as a lack of adequate information and supportive doc-
uments and also a lack of easy availability of such materials. Besides, disability
issues demand a wide range of program coverage including all common types of
disability in the community, which also requires easy availability of support ma-
terials and documents on different types and issues to develop plans and activi-
ties.
Persons with Disabilities have seldom got equal opportunities or congenial envi-
ronment, while deserving the opportunities to exercise their latent talent and po-
tentials and having rights to live in the society as equals. Thus, they are disad-
vantaged and need development projects that can help them to cope with prob-
lems to live normally. Sadly, disabled people are still in the most vulnerable
group, constituting 10% of the population.
Bangladesh cannot afford to keep more than 15 million disabled people as a
burden, so immediate attention of both the private and public sectors are needed
to transform the challenged people into productive members of the community.
A new Disability Rights Law in on the anvil to the great expectations of persons
with disabilities.(http://add.org.bd/wp-content/uploads/2013/07/Annual-Report-
2011-2012-29_10.pdf)
There are nearly 8 million voters with disabilities. They do not get to vote as
they thing it is not their rights. The right to vote is the most important political
right of a citizen. No citizen can be hindered or restricted du jure or de facto in
the enjoyment of political rights on the ground of disability. However, persons
with disabilities are often not aware of voting rights and backward in exercising
franchise due to barriers in the polling system. People with mobility problems

22
avoid voting for inaccessible polling centers. (http://add.org.bd/our-
programmes/promoting-economic-and-social-rights-and-electoral-rights-of-
persons-with-disabilities-in-bangladesh).
Considering the vulnerable situation of disabled people this study will be de-
signed. Findings of the study will help both government and the community de-
velopment organizations to undertake appropriate and need based interventions
for person with disabilities. The outcome of the study can be used widely within
the country as well as in the South Asian countries to raise awareness on specif-
ic issues and undertake development programs.
1.3 Objectives of the study
The main objective of the study is to assess the livelihood pattern of the person
with disabilities in Dhaka City. In this purpose the specific objectives are:
1. To know the demographic profile of the PWDs.
2. To know the socio-economic conditions & challenges of the PWDs.
3. To identify their basic needs and coping strategies.
4. To know the social attitude expressed towards the PWDs.
5. To know the opinions of PWDs to uphold their condition.
1.4 Definition of key concepts used in the study
Livelihood Pattern
Livelihood can be defined as a means of supporting one's existence, especially
financially or vocationally. In other sense, A livelihood comprises the capabili-
ties, assets (including both material and social resources) and activities required
for a means of living (Chambers & Conway, 1991).Livelihood pattern indicates
the way of living of a person or group or community that includes their educa-
tional level, occupation, recreational pattern, income, expenditure, health care
system etc. Generally livelihood pattern indicates a person's economic condition
and social status in the family and society.

23
Disability
The World Health Organization (WHO) defines disability as "an umbrella term,
covering impairments, activity limitations, and participation restrictions. Im-
pairment is a problem in body function or structure; an activity limitation is a
difficulty encountered by an individual in executing a task or action; while a
participation restriction is a problem experienced by an individual in involve-
ment in life situations. Thus disability is a complex phenomenon reflecting an
interaction between features of a person's body and features of the society in
which he or she lives"(WHO and The World Bank,2011).
PWD
Persons with disabilities include those who have long term physical, mental, in-
tellectual or sensory impairments which in interaction with various barriers may
hinder their full and effective participation in society on an equal basis with
others (UNs Convention on the rights of Persons with Disability, Article-1).
Dhaka city
In this study, Dhaka city refers to all those areas included under Dhaka City
Corporation.
1.5 Methodology of the Study
Research design
The study has followed mixed-methods design that facilitated both qualitative
and quantitative techniques of data collection.
Study Location
Dhaka City was the study location but due to time constraints, the part of differ-
ent areas prioritising Azimpur(14), Hajaribag(23), Lalbag(07) and Kamrang-
irchar(21 ) of Dhaka City of Bangladesh selected as location.

24
Sources of data
Data of the study was collected from both primary and secondary sources. Pri-
mary data was collected from selected samples through interview and question-
naire. Secondary data was gathered from published and unpublished research
reports, journals, books, as well as from record and documents of relevant
agencies.
Population of the study
All the PWDs aged 10 and above were considered the research population. Eve-
ry disable people were prioritized as the unit of the study who were the perma-
nent inhabitants of these areas.
Sample size and Sampling
A multi-faces sampling procedure got priority for this study. First of all, three
areas of Dhaka City were selected purposively then 65 respondents who are ca-
pable to provide essential information were selected through using purposive
sampling technique. Besides these, six case studies (four male and two female)
were conducted purposively that helped provide more qualitative data.
Data Collection Techniques
Primary data was collected by interview schedule. For this purpose, a structured
interview schedule (close and open ended) was prepared for data collection,
which was pre-tested. Requisite data was collected from the selected disable
people by face to face interview. Moreover, observation technique was applied
for data collection. Case study method was prioritized as well.
Processing and Analysis of Data
Firstly, the collected data from the research areas was edited. Then it was classi-
fied according to its characteristics. After that, it was analyzed through applying
different statistical procedures such as mean, percentage and so on. Processed

25
data was presented through different tables and appropriate graphs i.e. pie chart,
bar diagram, line graph etc.
1.6 Ethical Consideration
As a researcher, we received verbal consent from each participant. The aim and
purpose of the study were explained with the respondents then different ques-
tions were asked to them on the basis of that they expressed their response and
comments. All the respondents were given the assurance of confidentiality be-
fore conducting interview. As the researchers have no right to use any actual
names in the report without having the concerns of the participants, the re-
searcher used pseudo name here. Recording and field-notes were numbered and
coded with no personal identifying information in sight. The interviews were
conducted with privacy as much as possible. Alongside these, the researchers
also tried to their level best to show respect to all participants in the same man-
ner and maintain local norms, values and beliefs in all respect.
1.7 Limitation of the study
Generally, all the research work has some new arena of findings and some new
problems & prospects which are purposively manipulated to discover and cher-
ish an innovative outlook as well as better understanding. It can be acknowl-
edged that conducting research is completely based on scientific knowledge, at-
titude, skills and competence of the researcher. It is recognized that every re-
search has some concerned field and limitations due to its multifariousness. In
spite of our earnest efforts to conduct the study properly, we faced some imped-
iments during the study. Those impediments and limitations are stated below:
The study is based on the issue of the persons with disabilities. So the search-
ing of PWDs, identifying them and collection of data from then were very
hard for researchers.

26
In our country, a few organizations work with the PWDs and the geographical
area of this study was limited. So the respondents were selected purposively.
As a result, the findings of the study may not be similar or applicable for all
the times for all other persons with disabilities.
The study has been completed on the basis of sampling and case study. Here a
diminutive of sample has been purposively applied and a limited number of
cases have been analyzed. So it may not signify the national feature of the
PWDs.
In this study, some simple statistical methods have been used in data analysis
and data explanation. Conditions did not allow the apprentice social workers
to use more advanced methodological approaches of statistics.
As the persons with disabilities are socially neglected, physically disordered or
unsound, they showed reluctance to cooperate in many cases.
Proper data collection requires controlled and good environment. But we
could not maintain that in all cases. Noisy environment, congested areas, bad
smell, lack of sitting place and interference of other persons in the road sides
and slum areas created hindrance in collecting data from PWDs.
Due to limitation of time and shortage of relevant books, research paper and
journals regarding PWDs in our seminar and library, we could not make suffi-
cient literature review. In addition, there must have some printing mistakes
and language problem in presenting the research paper.
It will be better and reasonable, if the findings of this study are evaluated con-
sidering the above mentioned issues.

27
Chapter 2: Survey of Literature
Livelihood challenges for extremely poor disabled people in the south-
west coastal region of Bangladesh- by Prokriti Nokrek,Md. Arafat Alam
and Muzzafar Ahmed,January 2013
"Disability will affect the lives of everyone at some point in their life, it is
time society changed to acknowledge this."
One billion people, or 15 percent of the world's population, experience some
form of disability. One fifth of the estimated global total, or between 110 mil-
lion and 190 million people, encounter significant disabilities. Disability is a
major social and economic phenomenon in Bangladesh. Persons with disabili-
ties on average as a group are more likely to experience adverse socioeconomic
outcomes than persons without disabilities, such as less education, worse health
outcomes, less employment, and higher poverty rates. PWDs in Bangladesh
have been facing a strong difficult situation in their day-to-day lives, which bad-
ly impairs their socio-economic and cultural activities as well as the basic rights
and facilities as human beings and complete citizens of the country. A country's
economic, legislative, physical, and social environment may create or maintain
barriers to the participation of people with disabilities in economic, civic, and
social life. Barriers include inaccessible buildings, transport, information, and
communication technology; inadequate standards, services, and funding for
those services; and too little data and analysis for evidence-based, efficient, and
effective policies.
In January 2013 Prokriti Nokrek,Md. Arafat Alam, Muzzafar Ahmed conducted
a paper associated with Department for International Development (DFID),The
Government of Bangladesh (GoB), Save the Children, UKAID-SHIREE, CO-
DEC and PRODIPAN which title is "Livelihood challenges for extremely poor
disabled people in the southwest coastal region of Bangladesh."

28
This study showed that about 12 percent of extremely poor people suffered from
some kind of Disability and in Bangladesh many extremely poor disabled peo-
ple are still excluded from the social and economic activities that would allow
them to graduate from poverty and only about 31 percent of extremely poor dis-
abled household heads were receiving government safety net benefits, with only
about one half of these receiving the disability benefit. A significant proportion
of extremely poor people with disabilities go without government safety-net
benefits altogether.
Three different qualitative methods were used in this study: life histories, in-
depth interviews and focus group discussions to collect data. Life histories
method enabled the research team to explore respondents' lives and livelihoods
and their experience of discrimination in the work place.
All respondents were purposively selected to reflect a range of disabilities
(speech, hearing, sight, physical, behavioral and learning) and household com-
position (male-headed households, female-headed households and female-
managed households).
For the qualitative data collection, four upazilas in total (Dacope and Paikgacha
from Khulna district and Rampal and Mongla from Bagerhat district) were pur-
posively selected to give access to household heads with a variety of disabili-
ties.
The findings from the baseline report revealed that a total of 667 individual
beneficiary household heads were considered physically or mentally disabled by
other members of their household. Despite these challenges the need to focus on
improving the livelihoods of the disabled has not been sufficiently addressed in
development and poverty reduction initiatives.

29
Baseline data shows that out of 457 disabled household heads, 30 percent (137)
were not engaged with any income generating activities before the intervention
due to their disability. Another 20 percent of household heads solely relied on
begging. However, 50 percent of disabled household heads were working as
wage laborers (agriculture and other day labor), fishermen, transport workers
(such as van pullers) and housemaids. The baseline data also showed that about
73 percent of disabled household heads did not go to school.
Although 21 percent had completed study to primary level, only 5 percent had
completed junior Secondary school (up to grade eight). Only 1 person complet-
ed higher secondary school (grades 9-10) and 1 person completed their Second-
ary School Certificate. A similar pattern was reflected in the qualitative sample.
In this paper a number of sight or hearing impaired FGD participants talked
about their lack of special education and mentioned that due to a lack of special-
ly targeted medium of instruction for deaf and blind children they did not go to
school.
According to the screening survey 291 households (over 80 percent) with a dis-
abled household head received productive assets to establish small businesses,
undertake livestock and poultry rearing, set up grocery shops, buy sewing ma-
chines and mortgage in land. A number of disabled household heads (about 50
percent) also received skill-based training for small businesses, poultry and
livestock rearing and vegetable gardening.
This study showed that In 2001 the Parliament of Bangladesh enacted The Dis-
ability Welfare Act (DWA) 2001 (also known as Bangladesh Protibondhi Kol-
lyan Ain (BPKA)) whereby rights of persons with disabilities received statutory
recognition for the first time in the history of country. This act is primarily wel-
fare-based and emphasis is given to the impairment of the individual, but not on
social and environmental barriers.

30
This study showed that person with disabilities is often deprived, not only of so-
cial and political needs, but also basic human needs. This neglect is compound-
ed by a lack of availability of quality services for people with disabilities which
could otherwise ensure that they were able to participate in the mainstream de-
velopment activities. Their mobility is also seriously limited by traditional pat-
terns of building and road construction.
In this study some causes of disability has identified such as by born, illness,
high fever and lack of proper treatment. This paper had showed that Disabled
study participants faced significant challenges in maintaining income-generating
activities. Individual interview and focus group participants reported that the
situation was worse in rural areas compared with urban areas because of more
limited work opportunities, poorer education and health care facilities, and
higher levels of discrimination. This study also showed that People with disabil-
ity not only faced economic challenges but also experienced a variety of forms
of social or cultural exclusion, discrimination or stigmatization. Parental disabil-
ity also had negative effects on children's lives.
According to this study a number of disabled respondents from the FGDs and
individual interviews reported that they had experienced a range of exclusionary
attitudes in their daily life with in particular verbal attacks, jokes and bullying.
According to this study it is clear that disabled people are the most vulnerable
and disadvantaged group. Disabled people face significant challenges in main-
taining their livelihood activities. The most common limitation is an inability do
physical work over long periods due to physical impairments, which results in
prospective employers not wanting to recruit or hire them. A number of re-
spondents who had physical and mental disabilities experienced wage discrimi-
nation within the workplace. They are therefore deprived of employment oppor-
tunities and deprived of a fair wage. It was found that in particular those who

31
have visual, speech and hearing difficulties are deprived of special education
and other opportunities. As disabled people are not getting access to proper ed-
ucation, they are unable to get skilled jobs, driving them further into poverty.
Findings revealed that the ill health associated with their impairments often fur-
ther erodes their income and assets, as they lose working days and have to
spend money on treatment. Sometimes they are even forced to sell assets to pay
for treatment costs.
Findings also revealed that Disabled people are subjected to various types of
discrimination and negative attitudes in their daily lives. In particular women
with disabilities experience double discrimination. Respondents reported exclu-
sionary and discriminatory attitudes displayed in verbal attacks, jokes or bully-
ing. They reported exclusion from land inheritance. Children are also affected
by the negative attitudes and behavior of family members and wider society, of-
ten through bullying, which leads to low self-esteem. Thus discrimination, so-
cial exclusion and isolation are a frequent part of life, for both the disabled per-
son and their family. They are often neglected by their families, neighbors and
community.
This study showed some programs for addressing the problems of disabled per-
son such as ensuring savings plans to secure the future of disabled people, es-
tablishing networks with disabled people organizations to ensure community
based rehabilitation, and better access to assistive devices. Community based
rehabilitation can also improve skills and attitudes, support on the job training
and provide guidance to employers, Promote awareness through courtyard ses-
sions to reduce stigma and discrimination of disabled people. These could pro-
mote within-family caring for disabled people since the best people to provide
psychosocial support are families and communities.

32
World Report On Disability 2011
Produced jointly by WHO and the World Bank
Introduction
More than one billion people in the world live with some form of disability, of
whom nearly 200 million experience considerable difficulties in functioning. In
the years ahead, disability will be an even greater concern because its preva-
lence is on the rise. This is due to ageing populations and the higher risk of dis-
ability in older people as well as the global increase in chronic health conditions
such as diabetes, cardiovascular disease, cancer and mental health disorders.
Across the world, people with disabilities have poorer health outcomes, lower
education achievements, less economic participation and higher rates of poverty
than people without disabilities. This is partly because people with disabilities
experience barriers in accessing services that many of us have long taken for
granted, including health, education, employment, and transport as well as in-
formation. These difficulties are exacerbated in less advantaged communities.
To achieve the long-lasting, vastly better development prospects that lie at the
heart of the 2015 Millennium Development Goals and beyond, we must em-
power people living with disabilities and remove the barriers which prevent
them participating in their communities; getting a quality education, finding de-
cent work, and having their voices heard. Many people with disabilities do not
have equal access to health care, education, and employment opportunities, do
not receive the disability-related services that they require, and experience ex-
clusion from everyday life activities. Following the entry into force of the Unit-
ed Nations Convention on the Rights of Persons with Disabilities (CRPD), disa-
bility is increasingly understood as a human rights issue. Disability is also an
important development issue with an increasing body of evidence showing that
persons with disabilities experience worse socioeconomic outcomes and poverty
than persons without disabilities.

33
Despite the magnitude of the issue, both awareness of and scientific information
on disability issues are lacking. There is no agreement on definitions and little
internationally comparable information on the incidence, distribution and trends
of disability. There are few documents providing a compilation and analysis of
the ways countries have developed policies and responses to address the needs
of people with disabilities.
As a result, the World Health Organization and the World Bank Group have
jointly produced this World Report on Disability to provide the evidence for in-
novative policies and programs that can improve the lives of people with disa-
bilities, and facilitate implementation of the United Nations Convention on the
Rights of Persons with Disabilities, which came into force in May 2008. This
landmark international treaty reinforced our understanding of disability as a
human rights and development priority.
The overall aims of the Report are:
1. To provide governments and civil society with a comprehensive description
of the importance of disability and an analysis of the responses provided,
based on the best available scientific information.
2. Based on this analysis, to make recommendations for action at national and
international levels.
Concept
Disability is the umbrella term for impairments, activity limitations and par-
ticipation restrictions, referring to the negative aspects of the interaction be-
tween an individual (with a health condition) and that individual's contextual
factors (environmental and personal factors) .
The International Classification of Functioning, Disability and Health (ICF)
advanced the understanding and measurement of disability. It was developed

34
through a long process involving academics, clinicians, and ­ importantly ­ per-
sons with disabilities. The ICF emphasizes environmental factors in creating
disability, which is the main difference between this new classification and the
previous International Classification of Impairments, Disabilities, and Handi-
caps (ICIDH). In the ICF, problems with human functioning are categorized in
three interconnected areas:
Impairments are problems in body function or alterations in body structure ­
for example, paralysis or blindness;
Activity limitations are difficulties in executing activities ­ for example, walk-
ing or eating;
Participation restrictions are problems with involvement in any area of life ­
for example, facing discrimination in employment or transportation.
Disability refers to difficulties encountered in any or all three areas of function-
ing. The ICF can also be used to understand and measure the positive aspects of
functioning such as body functions, activities, participation and environmental
facilitation. The ICF adopts neutral language and does not distinguish between
the type and cause of disability ­ for instance, between "physical" and "mental"
health. "Health conditions" are diseases, injuries, and disorders, while "im-
pairments" are specific decrements in body functions and structures, often iden-
tified as symptoms or signs of health conditions.
Situation
Negative imagery and language, stereotypes, and stigma with deep historic roots
persist for people with disabilities around the world. Disability is generally
equated with incapacity. A review of health-related stigma found that the impact
was remarkably similar in different countries and across health conditions. A
study in 10 countries found that the general public lacks an understanding of the
abilities of people with intellectual impairments. Mental health conditions are

35
particularly stigmatized, with commonalities in different settings. People with
mental health conditions face discrimination even in health care settings. Nega-
tive attitudes towards disability can result in negative treatment of people with
disabilities, for example:
1. Children bullying other children with disabilities in schools
2. Bus drivers failing to support access needs of passengers with disabilities
3. Employers discriminating against people with disabilities
4. Strangers mocking people with disabilities.
Negative attitudes and behaviors have an adverse effect on children and adults
with disabilities, leading to negative consequences such as low self-esteem and
reduced participation. People who feel harassed because of their disability
sometimes avoid going to places, changing their routines, or even moving from
their homes .
Disability is a human rights issue because:
1. People with disabilities experience inequalities ­ for example, when they are
denied equal access to health care, employment, education, or political par-
ticipation because of their disability.
2. People with disabilities are subject to violations of dignity ­ for example,
when they are subjected to violence, abuse, prejudice, or disrespect because
of their disability.
3. Some people with disability are denied autonomy ­ for example, when they
are subjected to involuntary sterilization, or when they are confined in insti-
tutions against their will, or when they are regarded as legally incompetent
because of their disability.

36
The onset of disability may lead to the worsening of social and economic well-
being and poverty through a multitude of channels including the adverse impact
on education, employment, earnings, and increased expenditures related to
disability.
1. Children with disabilities are less likely to attend school, thus experiencing
limited opportunities for human capital formation and facing reduced em-
ployment opportunities and decreased productivity in adulthood.
2. People with disabilities are more likely to be unemployed and generally earn
less even when employed. Both employment and income outcomes appear
to worsen with the severity of the disability. It is harder for people with dis-
abilities to benefit from development and escape from poverty due to dis-
crimination in employment, limited access to transport, and lack of access to
resources to promote self-employment and livelihood activities.
3. People with disabilities may have extra costs resulting from disability ­ such
as costs associated with medical care or assistive devices, or the need for
personal support and assistance ­ and thus often require more resources to
achieve the same outcomes as non-disabled people. This is what Amartya
Sen has called "conversion handicap". Because of higher costs, people with
disabilities and their households are likely to be poorer than non-disabled
people with similar incomes.
4. Households with a disabled member are more likely to experience material
hardship ­ including food insecurity, poor housing, lack of access to safe
water and sanitation, and inadequate access to health care.Poverty may in-
crease the risk of disability. A study of 56 developing countries found that
the poor experienced worse health than the better off . Poverty may lead to
the onset of a health conditions associated with disability including through:
low birth weight, malnutrition, lack of clean water or adequate sanitation,

Details

Pages
Type of Edition
Erstausgabe
Year
2014
ISBN (PDF)
9783954899821
ISBN (Softcover)
9783954894826
File size
2.5 MB
Language
English
Publication date
2015 (September)
Keywords
Disability Dhaka Bangladesh Dacca Livelihood Disabled Socio-economic Case study Health care Public health Livelihood pattern Persons with disabilities
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