Community-driven efforts help disabled Afghans

Afghanistan is home to an estimated 800,000 disabled people - maimed from mine explosions or crippled by diseases such as polio or cerebral palsy. Despite the absence of a recognised government, an innovative UNDP-funded scheme is working to develop a national policy for the rehabilitation of the country’s marginalised disabled people.

The Comprehensive Disabled Afghans Programme [CDAP] believes that most disabilities in Afghanistan are preventable, while many can be controlled if they are detected early, and simple coping mechanisms and knowledge are transferred to families and communities. Last year the programme directly supported 35,000 disabled people and established 28 community rehabilitation centres in a bid to bring more awareness, responsibility and ownership to the community level.

Almost 50 percent of Afghanistan’s disabled people suffer from mobility difficulties - the combined effect of mine injuries and lack of proper health services. However, orthopaedic workshops staffed by trained Afghan nationals are providing technical aids such as artificial limbs, wheelchairs and walking devices. An average of five to six disabled people receive orthopaedic appliances from each of the country’s 12 workshops each day. “Our aim is to make these people mobile, maximise their mental health and physical ability before integrating them back into the community,” Dr Farooq Wardak, national programme officer for CDAP, told IRIN.

Much can be achieved through surgery, CDAP maintains, to correct existing deformities such as club foot, cleft palate and contractures from polio and burns, and prevent them from becoming permanent disabilities. However, surgical services in Afghanistan are weak or nonexistent. Former specialist medical units such as eye and hearing hospitals and plastic surgery clinics have been closed as a result of war.

The many years of fighting have also indirectly led to other diseases, including an increase in tuberculosis of the spine, fractures and delayed development of children due to malnutrition. Physiotherapists are playing a leading role in their rehabilitation. Sixteen years ago, Afghanistan had only two trained physiotherapists, both of whom had studied overseas. Today, there are almost 100 physiotherapists and 53 assistants working with NGOs countrywide.

Education for marginalised Afghans remains a priority, and efforts are being made to give disabled children access to mainstream schools by removing barriers to their integration. Special education programmes for those whose hearing is impaired, such as training in sign language and lip-reading, as well as Braille, and mobility support for visually impaired Afghans, have facilitated their incorporation as equal members of village schools and communities. The first-ever dictionary of Afghan sign language, containing about 2,000 words, is about to be published in a country where reference books are scarce.

Vocational training courses have armed many disabled Afghans with tangible skills and trades like carpet weaving, sweater knitting, tailoring, local hat weaving and water pump repairing. Some have managed to find jobs in government schools, NGOs and private companies.

Despite these positive measures, CDAP remains lacking in sufficient funds to enable it to extend its programme to rural areas. “We need centres in remote areas where people have difficulty moving around and are losing out,” Wardak said. A funding shortfall last year forced the programme to close 22 of 66 of its operations.

Rehabilitation was a long process, Wardak stressed, and staff willing and able to dedicate time to people with special needs were hard to come by. Now, with the resumption of summer fighting between the Taliban and Northern Alliance, the need for special programmes for the disabled is greater than ever. “There is a lot of potential for us to work out there and have an even wider reach. But we need the funds to do it,” Wardak said.