“When given [the] chance, physically-challenged children are more than capable of overcoming barriers to their inclusion, of taking their rightful place as equal participants in society and of enriching the life of their communities. But for far too many children with disabilities, the opportunity to participate simply does not exist. Far too often, children with disabilities are among the last in line for resources and services, especially where these things are scarce to begin with. Far too regularly, they are the objects simply of pity or worse, discrimination and abuse.” This is what Anthony Lake, Executive Director Unicef, writes in his foreword to the State of World Children 2013.

The foreword goes on to say that “inclusion of children with disabilities in society is possible — but it requires first a change of perception, a recognition that children with disabilities hold the same rights as others; that they can be agents of change and self-determination, not merely the beneficiaries of charity.” It is past time that we accepted that people with disabilities have the potential to lead fulfilling lives and to contribute to the social, cultural and economic vitality of their communities; provided they are given the opportunity to do so.

Poverty or being a member of a minority group, present additional challenges.

Children living in poverty are least likely to enjoy the benefits of education and healthcare, for example, but children who live in poverty and have a disability are even less likely to attend school or visit a health facility.

“I was given that opportunity. I was a child with a disability who attended primary school, and then medical college. This was because my parents were educated,” says Dr Narain Jagani, in-charge of a hospital in Mirpur Khas who had polio when he was less than a year old. “We cannot over-emphasise the importance of education. Parents should not think twice about it.” He feels the first step is for physically challenged people to be educated and trained in some set of skills. Then comes their inclusion and mainstreaming into services, public or private, which should be mandatory.

“I have always had to prove myself, when competing with others, whether at college or at work. As I was growing up, there were places I could not go to or activities I couldn’t participate in. Being a doctor, my worst moment is when I have to refuse a patient just because his/her home is inaccessible to me. Being unable to help someone in need due to my own mobility issue pains me. That’s the time I really feel the pinch,” adds Dr Jagani Abeer Khan, a visually impaired school teacher, feels that when it comes to disability, girls are disadvantaged in our society. Girls are less likely than boys to receive care and food and are more likely to be left out of family interactions and activities. They not only confront the prejudice and inequities encountered by many people with disabilities, but are also constrained by traditional gender roles and barriers. Girls with disabilities are also less likely to get an education, receive vocational training or find employment than are boys with disabilities or girls without disabilities.

Outlining the barriers, Luna Hashmat, CEO Civil Society Human and Institutional Development Programme, says there are many people living in isolation because they are perceived as a symbol of embarrassment for the family.

High level of dependency on family members for even basic needs, living in a bewildered state of mind with no future vision, no referral facility at village and tehsil level, no medical assessment, no access to assistive devices and trainings on independent living are just some of the problems faced by the physically challenged. They are also not included in communal decision-making because of physical disparities.

Some of the other major issues are out-of-the-way houses/surroundings, inaccessible schools and not being included in sports, etc. Skill-learning centres are needed to cater to their needs.

Life for wheelchair-bound folks is very difficult in Pakistan. In most countries of the world, building regulations mandate that all construction is to be done with wheelchair accessibility and all facilities should have “disabled-friendly” washrooms.

“Once you are in a wheelchair you realise how difficult it is to enter buildings and public facilities as there are no ramps; there may be an elevator inside the building but there will always be some steps at the entrance which are impossible to negotiate in a wheelchair. With the current electricity problem, if you go some place where you need to take a lift, you better make sure that the lift has a back-up generator. Moreover, the wheelchair is bulky and difficult to carry when travelling, an aspect that manufacturers need to pay attention to. On a lighter note, the advantages are that people are always ready to give you a helping hand, always ready to let you go first when in a queue,” says Rumana Reza, a trainer.

Prof. Rizwan Taj, head of psychiatry at the Pakistan Institute of Medical Sciences, and National Focal Person Mental Health also feels the problem is enormous relative to the few, scanty services being provided. “The general population has little understanding of the psychological impact this group suffers. Most public utilities do not have friendly-to-use facilities. Employment opportunities are lacking; though there is a special quota of jobs reserved for the physically challenged in state services this rule is not strictly followed. On the social scene such people are stigmatised and less likely to find partners.”

There are many issues faced by people with disabilities. Accessibility to public buildings, lack of support for rehabilitation, both in terms of the tools and the treatment, social stigma, lack of integration into the mainstream, especially in terms of education, lack of employment opportunities that cause financial stress, expenses and medical bills; and with all of this also an overall lack of access to Pakistani society. The physically challenged are marginalised often without access to the same opportunities for employment, for mobility, for access, for services, freely available to able-bodied people.

Dr Quamrul Hasan from the World Health Organisation says, “As a general observer I can say provision for special people is not considered in most of the public places/facilities, e.g. entry in banks, offices, institutions, bus/railway station etc. Though, I learned that this is required by the country’s law.”