INTRODUCTION

1.1 Background
Voluntary Services Overseas (VSO) is an international development agency that works in development through volunteering. It works to build the capacities of local partner organisations in the South by bringing people together to share skills, creativity and learning in order to change lives. Internationally, VSO works in 34 countries in the South, in six goals areas namely: Education, HIV/Aids, Health, Disability, Secure Livelihoods and Governance. The Programme office of The Gambia works in three of the goal areas i.e. education, secure livelihood and disability.

Sources: Harwood et Al (2004) Current and Future Worldwide prevalence of Dependency, its Relationship to Total population and Dependency Rates.

The majority of Africans with disabilities are excluded from schools, opportunities to work and participate in poverty reduction programs, virtually guaranteeing that they will live out their lives as the poorest of the poor. Although PWDs are amongst the poorest, they were not included in rural poverty alleviation programmes (ESCAP, 1999). For example in Rwanda, PWDs share the general profile of the non-disabled poor. They typically lack access to health and education, clean water and sanitation, have poor housing and may live in over-crowded, unsanitary and unsafe areas. However, for PWDs, their lives are typically so much harder because of their impairments. In Rwanda, on average people have to walk 750m to get water; for someone with a mobility problem, this may be an impossible distance. (Thomas 2005).
The social stigma associated with disability results in marginalization and isolation, often leading to begging as the sole means of survival. A consequence of living in poverty with a disability is inadequate access to health services, resulting frequently in serious secondary conditions and general deterioration of the quality of life. Additional complications are caused by inaccessible health services and lack of knowledge about health implications of disabling conditions.
Africa has seen a wave of DPOs coming together to lobby and advocate for rights of
PWDs after the lessons learnt in the United Nations Decade of Disabled 1983-1992
Disability issues started to come up on Governments’ agenda from a few African states
such as South Africa, Uganda, and Rwanda but were not priority areas of Interventions
DPOs and Federations worked with international organisations such as DFID, VSO and
Sightsavers International to address disability issues.
The UN decade 1983-1992 did not bring about much improvement in the quality of life of people with disabilities in Africa mainly due to low political will and failure to implement the WPA (SADPO, 2008). Thus the celebration of the end of the UN decade in 1992 prompted the African Disability Movement to lobby and gain UN support for the African Decade of Disabled Persons
The Pan African Federation of the Disabled (PAFOD) congress held in Lusaka in October 1994, endorsed the idea and developed proposals for a concept paper on its objectives. The African Union of the Blind (AFUB) similarly echoed the idea at their congress meeting held in Nairobi, Kenya in 1996. A continental plan of action for the African Decade of Disabled Persons was developed in Addis Ababa in February 2002. At its first ordinary session, the Executive Council of the African Union, meeting at Durban (9-10 July 2002), endorsed the “Plan of Action for the African Decade of People with Disabilities” in its regulation no. 7, “African Decade of Disabled Persons”. The Republic of South Africa accepted to host the Secretariat of the African Decade for Persons with Disabilities (SADPD) and the Secretariat started its first regional office in West Africa in Dakar, Senegal in 2006.
African Decade of Persons with Disabilities was extended to December 2019. The extension was declared at the AU ministers in Charge of Development meeting held in
Windhoek, Namibia on 27th - 31st October, 2008. The Windhoek Declaration on Social
Development adopted by Ministers in Charge of Social Development, adopted
Resolution 6, which reads as follows:
“Adoption the extension of the Continental Decade of Persons with Disabilities for the period 2010-2019; Call for the evaluation of the existing Decade and its Plan of Action
(1999-2009) and the speedy conclusion of the evaluation and restructuring of the
African Rehabilitation International (AR1)”
In addition to the resolution extending the Decade, the Windhoek Declaration also adopted resolution 5(x) which reads as follows:
“Further commit ourselves to implement the priority strategies under the key thematic social issues spelt out in the Social Policy Framework for Africa, through the following:
Empowering and providing persons with disabilities with equal opportunities, safeguarding their rights and enlisting their participation and mainstreaming them in all development programmes” (SADPD October 2008).
The UN Convention on the Rights of Persons with Disabilities (UNCRPD) came into force in May 2008; some African States have ratified the Convention and the optional protocol as follows;
Table 4: African Countries that have ratified the UN Convention and Optional Protocol
Once a country ratifies the Convention, it will need to be reflected in its national development framework such as the Common Country Assessment (CCA), United
Nations Development Assistance Framework (UNDAF), and Poverty Reduction Strategy Papers (PRSP). It is through these broad-reaching approaches to development that the
Convention will become a reality on the ground and in the daily lives of individuals The Secretariat of the African Decade of Persons with Disabilities and DPOs continue to encourage, lobby and advocate other countries and their governments to ratify the Convention.
African Governments can protect and promote human rights with limited resources. In recognition of the resource limitations that many governments face in implementing human rights law, many aspects of implementation of the Convention will be a progressive process. However, limited resources are not an excuse to delay implementation of the Convention and must also not be used to justify limiting the scope of the beneficiaries of the provisions in the Convention. International cooperation will be helpful in supporting the process and resources will have to be prioritized according to reasonable and objective criteria.
PWDs are often subjected to discrimination, whose negative consequences are particularly severe in resource-poor countries. Discrimination results in being denied equal access to social and economic opportunities and benefits. It also reinforces a climate of low expectations and negative stereotyping, which further limits potential. Such handicaps can be overcome only through public education and affirmative actions aimed at empowering people with disabilities and ensuring them a place in mainstream society. (Dudzik, Elwan, and Metts, 2000)
In an effort to contribute to National Development DPOs have implemented some programmes that address the concerns of PWDs in different countries such as Tanzania, Uganda and Zimbabwe. DFID funded the implementation of rights of wheel chair users in the above countries in 2004. PWDs are the most qualified people to advocate for appropriate design and implementation of policies and strategies to facilitate their contributions to society. Therefore, support for and constructive engagements with DPOs are the most cost-effective investments available to nations and international organizations wishing to increase the socio-economic participation of PWDs. (Dudzik, Elwan, and Metts 2000)
Examples of some of the Projects implemented in 2005 by Civil Society Organisations are; Mainstreaming poor mentally-ill people in the informal settlement of Kangerni, Nairobi, Kenya; Building the capacity of PWDs in Uganda to access their livelihoods; Empowerment of DPOs in Angola; Empowering Deaf blind People in East Africa; all funded by DFID. (Thomas 2005)
The Federation of Disability Organisations in Malawi (FEDOMA) in November 2004 hosted the first roundtable on Disability, Poverty and Millennium Development Goals, which was attended by 39 participants from Africa, India, South East Asia and Europe. Among them were representatives of government ministries, international NGOs, and regional, national and grassroots DPOs.
Participants identified a number of challenges to getting disability on the policy agenda. These included: disability being seen as a low priority by decision makers: lack of DPO capacity and unity; policies not being communicated down to the grassroots level; disability issues still being regarded in isolation.
A number of solutions were suggested, involving capacity building for DPOs, development of networks, increased lobbying, awareness raising of the effect of policies, and skills-building for OPOs. These suggestions were developed into a framework for action for use at national and international levels. (Thomas 2005)
In Namibia a project 2004-9 is being implemented by VSO/PDDs funded by European Commission. The aim is to empower people with disabilities to access improved support services and participate fully in all aspects of society. The specific objectives are:
§ To ensure effective delivery of DPO programmes and empowerment of their members across five target regions of Namibia through institutional strengthening, and improved co-ordination & networking;
§ To reduce the levels of stigma and misconception about disability in Namibian society by increasing public awareness, depth of understanding, and informed political responses to disability issues.
Children With Disabilities Empowerment Programme (CDEP) — Kenya. The CDFP project has been running since 1998, managed by VSO Kenya, with funding from the European Commission. CDEP’s goal is to secure equal educational opportunities for children with disabilities through capacity building of complementary and integrated agencies in Kenya’s disability sector, The total cost for the programme over nine years is approximately €2 million. The project has identified and helped meet the needs of children with disabilities through building the capacity of Education Assessment Resource Centres to train teachers and other related professionals, and to mobilise parents and their communities to support children with disabilities. The project has supported interventions that have provided children with disabilities with increased access to appropriate education, community based rehabilitation (CBR) and other relevant services.
The CBR strategy of CDEP has proven to be a powerful tool with enormous potential to empower local people to provide support for children with disabilities. In the special needs education field, COEP has successfully developed in-service training and materials, which complemented the graduate teacher training, run by the Kenyan Institute for Special Education. As a result there are more teachers trained in skills in which there were serious shortfalls.
COEP has also supported the United Disabled People of Kenya (UDPK) to engage in national and local advocacy with their supporters and partners. As a result UDPK has achieved recognition as the main advocate of the disability movement and has started to articulate the needs of people with disabilities to contribute to national debate about their rights and to help formulate inclusive policies.
The Uganda umbrella organization of OPOs, National Union of Disabled Persons in Uganda (NUDIPU), has a highly advanced disability movement in Uganda) expansive disability legislation, and representation of PWDs at all levels of government - with NUDIPU itself having five seats in Parliament. NUDIPU, formed in 1987, is very well established. It includes all kinds of disability and gets its voice heard throughout Uganda by being represented from village to national level. NUDIPU is frequently consulted by the government on matters related to disability. Firmly integrated into Uganda’s disability movement, NUDIPU’s aims are to bring PWDs together, create a common and unified voice, break traditional divisions built along medical lines, raise awareness of problems and issues affecting PWDs and mobilise their efforts in developing strategies and implementing action to address their needs. It advocates for the equalisation of rights and opportunities for PWDs, and helps its member associations to get funding. The organisation is very much inspired by the slogan ‘Nothing for us without us’, with planning, managing, implementing and monitoring of all its programmes done by and for PWDs. For NUDIPLI, disability is a human rights issue. (Thomas 2008)
Employment opportunities for people with disabilities in Africa are small. Existing data from developing countries shows that PWDS are less likely to be engaged in economic activity than the rest of the population. The ILO notes that unemployment rates for people with disabilities can be two or three times higher than for those without disabilities (ILO Report 1984).
2.3 Disability in Gambia context
There is limited up to date statistics on disability prevalence in The Gambia. However, applying the global estimate that 10% of the population in any country are PWDs at any given time indicates that there about 15, 000 PWDs (10% of 1.5m) in the country. Taking an average of 22/1000 (16/1000 from 1998 National Disability Survey and 23/1000 from the 2003 National population Census), the number of PWDs in The Gambia would be approximately 33,000
The magnitude of disability is a growing phenomenon in the Gambia noting the prevalence rate of 16 per thousand (16%) of the population, according to the figures of 1993 national disability survey, compared to 23 per thousand 2.8% of the population by the national population and housing census of April 2003. The gender differentials for males and females for the 1998 survey was 17.4 and 13.9 per 1000 respectively. Physical mobility related disability constituted the highest national prevalence rate of 3.6 pre 1000 population. The urban and rural prevalence rates were 12.5 and 17.6 per 1000 population respectively.
1310 (31%) out of the 4253 PWDs enumerated in the 1998 National Disability Survey were children between 2-18 years of age. The main disability problem of these children was difficulty in speech which constituted 18.4%. Visual impairment and hard of hearing were also reported among children but were not as high as speech difficulties. In any case, all the mentioned types of disabilities among children could negatively influence their educational opportunities if special services are not available to them. In 2003 population and housing census, visual impairment had the highest prevalence rate of 1.1 per hundred. This was followed in second place by physical impairment (0.6 per 100) and third by hearing impairment (0.4 per 100).
The debate about poverty & disability has been active for many years. Of late many international agencies in the Gambia such as VSO, Sightsavers, Government, OPOs etc. particular have begun to emphasise poverty reduction in their statements on disabilities. The joint position document of the Incorporated Vision 2D2D, PRSP I & II, and the MOGs components recommended poverty reduction as a key strategy in policies and services, including community based rehabilitation for PWDs. This acknowledges the fact that poverty & disability can form a vicious circle. Poverty is generally held to be a major cause of impairment & disability in developing countries and many kinds of impairment are the result of specific diseases or conditions that are preventable. On the other hand, PWOS are likely to become poorer because impairment or disability places heavy demand on limited resources, and reduces access to opportunities for education or livelihood as the case at hand in the Gambia PRSP II.
Although it is generally acknowledged that disability can be a cause and consequence of poverty, it is difficult to make generalizations. The relationship between poverty and disability is complex and can differ according to the context, and according to the definitions of disability and poverty that are used. However, what is undisputed is the fact that PWDs are disproportionately represented among the poor, as shown by the 1998 National Disability survey. This underscores the need for govt. NGOs and other agencies involved in disability issues to address poverty reduction, and for those involved in other development programmes to include PWDs in their activities for poverty reduction, and empowerment. The understanding of poverty goes beyond income levels, and encompasses exclusion and lack of power. Addressing poverty reduction would thus mean going beyond traditional vocational training and income generation activities that are commonly seen or aspired by DROs’ programmes. The current world-wide emphasis on inclusion, participation, and self advocacy and on the rights-based approach to disability brings out the need for strategies to address different aspects of disability in the Gambia.
Over the years, the Department of Social Welfare, education, VSO and , Sight Savers in collaboration with OPOs, have demonstrated workable strategies and programmes at macro/central level to address issues like rehabilitation, mainstream education, capacity building activities, empowering people with disabilities and institutional building for enhanced service delivery.
These are 8 DPOs that are registered with the umbrella body - Gambia Federation of the Disabled (GFD)
§ Gambia Association of the Physically Disabled (GAPO)
§ Gambia Association of the Deaf and Hard of Hearing (GADHOH)
§ Gambia Organization of Visually Impaired (CCVI)
§ Gambia Association for Learning Difficulties (GOLD)
§ Gambia National Paralympics Committee (GNPC)
§ Association for the Mentally Disabled of the Gambia (AMDG)
§ National Union of Disabled Youths (NUDY)
§ Rural Support Organization for the Disabled (RSOD)
Other DPOS that exist but are not members of the Federation include:
§ Foundation For Disabled People in The Gambia
§ Bundurg Association of the Disabled and their Children (BADAC)
§ Second Home Foundation
§ Hart House Home for Children with Learning Difficulties
§ Save the Children with Learning Difficulties
The government of the Gambia offers both moral and financial support to some of these DPOs through annual subventions, and helps champion their cause in the quest for empowerment and development of the PWDs.
Services
As is in most developing countries, the social welfare support system for PWDs in The Gambia is not well developed. PWDs are hence, in most cases, reliant on the support from within the family,
There is currently inadequate communication between the public service providers and the disabled community in The Gambia and this resulted to insufficient understanding of PWD needs among some service providers. Key pubic service providers are the Royal Victoria Teaching Hospital (RVTH), The Gambia’s three special schools for children with disabilities, mainstream schools, and the National Rehabilitation Centre (NRC) within the DoSW (see list of some service providers in the appendix).
Key constraints of these service providers include:
- The RVTH is the main referral hospital for all conditions including disability. However, awareness of the existence of such services and the cost of the services could be a limiting factors to their utilisation by the rural poor especially women and hence many such cases can go undiagnosed.
- The three special schools in The Gambia are also under-resourced and lack adequate capacities needed to ensure that all the needy students receive a basic education. However all teachers in training at Gambia College are receiving input on Special Education as part of their curriculum and some in the special schools have also had recent training in this area.
- Children with disabilities in mainstream schools across the country used to be rnarginalised by both the teachers and other students. This attitude is fading as more skilled personnel are trained to deal with these special children.