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UN Programme on Disability   Working for full participation and equality

2001 Observance of the
International Day of Disabled Persons

International Day of Disabled Persons 3 December 2001

United Nations expert group meeting on disability-sensitive policy and programme monitoring and evaluation
UNHQ, New York, 3-5 December 2001

Caribbean Region*

By Monica Bartley, December 2001

Background

Over the past 10 years significant strides have taken place in the disability movement in the Caribbean region. The movement has evolved from that of a charitable rehabilitation model to that of self-advocacy by persons with disabilities. This has been quite evident in the visibility of persons with disability in society. This change has resulted from the combined efforts of the government and non-governmental organizations. However there is need for a comprehensive evaluation in terms of the measurement of the impact of policies and programmes implemented to determine the extent to which the quality of life of persons with disability has changed. This is compounded by the fact that various organizations are implementing programmes towards achieving the goal of equalization of opportunities for persons with disabilities.

Prior to 1981 in many countries in the Caribbean region, services for persons with disabilities were limited, so policies evolved more in response to the demands of local self-advocates driven by networking with international organizations like Disabled Peoples' Organization. The lack of data for planning and development of policy comes into sharp focus, as there is a reluctance by both the public and private sector to put in the necessary infrastructure as the feeling exists that not enough persons would utilize such facilities. This view however, was counteracted through strong advocacy by disabled persons, in the absence of statistical data to support the need. Although significant changes have taken place over the period being reviewed there is insufficient data to evaluate the progress made.

Prevention

There is a well established immunization programme which is sustained through vigilance and constant monitoring as experience has shown that when the levels are low a polio epidemic may reappear as happened in the early eighties.

There are other programmes aimed at preventing impairments through education nutrition, and health care opportunities. Government for example, instituted a food stamp program to assist pregnant mothers and young children as well as emphases on early detection of chronic diseases, such as hypertension and diabetes, have led to better management of these diseases, which can result in disability.

More recently motor vehicle accidents are a contributory factor to the number of disabilities, which resulted in laws being enacted to underpin the need for ensuring that preventative measures are in place and adhered to. These include the seat belt law of November 2000. Also the phasing out of leaded gasoline, which impacted, on the environment.

Rehabilitation

Efforts in rehabilitation continue through various programmes offered by both the public sector and NGO's. There is one specialized institution for rehabilitation of physically disabled persons with smaller units in major public hospitals in the country. The NGO's contribution is quite significant also in particular the special schools for example, the Salvation Army School for the Blind, (catering for children) and the Jamaica Society for the Blind that offers mobility and other rehabilitation programmes for adults.

The acquisition of technical aids and appliances has improved to a marked extent subsidized by government through the Rehabilitation Centre as well as from the assistance given by varied donors such as the Jamaican based "Food for the Poor". However the matter of affordability is still a problem particularly for persons in the rural areas who do not have easy access to the services provided.

In the last decade there has been something of a revolution in the approach to provision of services. An increasing recognition has developed that needs can be met by utilizing community resources rather than the traditional, centralized, specialized and costly institutional services offered in more developed countries hence the focus on Community Based Rehabilitation. There are three such organizations one government and two non-governmental offering such services in Jamaica.

Although considerable progress has been made in this area over the past 20 years the number of children still underserved is very high. There is a severe unmet need for readily accessible psychological assistance in the schools. Some disabilities particularly mental retardation speech and visual are often not recognized. This may be related to the accessibility of services, which is very poor in most rural parishes in the Caribbean.

The availability of new technology which while opening up new opportunities can have a negative impact in terms of the ability of most persons to obtain such particularly in developing countries where resources are scarce. In fact to date very few persons have been able to access this. Ownership of most of these types of equipment is limited to institutions such as University of the West Indies for the accommodation of visually and hearing impaired students.

Equalization of opportunities - integration into society

Several organizations of and for persons with disabilities were established since IYDP in 1981. Over the period they have been instrumental in bringing about change by advocating for the rights of disabled persons. This process resulted in heightened awareness and sensitization of the needs of disabled persons as well as some move towards integration in the society. However although there has been some measure of progress there is still a far way to go as barriers towards access to education, employment, buildings to name a few still exist which has resulted in the majority living a life of poverty.

Most of the Governments in the region are now aware of the issues and do provide some measure of support. In fact most of them are in the process of preparing disability policies however, due to lack of resources not much funding is allocated to disability programmes.

A National Policy on Disability based on the Standard Rules was implemented in September 2001 in Jamaica outlining the various goals, objectives and strategies with the aim of achieving equal opportunities for person with disabilities. Some of the strategies are being implemented by various organizations but the extent to which the goals are being met are not being measured in a meaningful way. Adequate monitoring mechanisms have not been put in place as well as a coordinated approach is required for full implementation.

Transportation

Accessible transportation is one of the major problems for the disabled especially persons living in the rural areas. Concessionary bus fares, were introduced but the buses are not accessible. In an effort to address this situation two buses equipped with wheelchair lifts were designated to transporting persons with disabilities and the aged in the metropolitan areas. The rural areas do not enjoy this benefit. Integration with the wider public is not facilitated as the service is extended to caregivers and relatives only.

Education

Access to education is one of the major impediments faced by persons with disabilities. Over the period significant advances have been made in the area. The Ministry of Education has established a Special Education Unit, which address the specific needs of the sector and is presently in the process of developing a policy. There is however in existence a White Paper on Education which includes policies relating to children with disabilities.

A Braille unit was set up to produce textbooks in Braille and large print for visually impaired persons. This has facilitated children with visual impairments to sit all national exams along with other students. This is used for bench marking as well as for placement in secondary schools as long as they are capable. Provisions are also made for children with learning disabilities to allow them to complete the examinations under special conditions. The matter of access has also been addressed, as all new schools being constructed now are being made accessible for wheelchair users.

Prior to the mid-nineties very few persons attained tertiary level education. The University of the West Indies has taken steps to address this by setting up a Committee for Students with Special Needs. To ensure that adequate proportion of persons with disabilities in the relevant age cohort to the non-disabled attend the university. A survey was done in the secondary schools to determine the number of students with disabilities, with a view to assisting the students with matriculation requirements for the university. Since then there has been a marked increase in the number of students with disabilities entering and graduating from the university. It has been noted that there are more blind and visually impaired students enrolled in the university which could be as result of blind children having better access to education at the primary level through the School for the Blind, a residential facility, while physically disabled children are faced with the problem of inaccessible school buildings and high transportation cost to go to school. It is not clear how many of the persons who have graduated from the university have obtained employment.

Housing

The matter of affordable and accessible housing is another problem faced by disabled persons. This was addressed to some extent by a special provision of government for a percentage of houses in each scheme, constructed by one of its agencies, to be allocated to persons with disabilities. Although this benefit is offered not many persons are able to take up the offer, as they do not satisfy the financial requirements.

Vocational Training

The Abilities Foundation, a vocational training center for persons with disability, was established in 1991. It offers a comprehensive skills training program to meet the needs of the entire spectrum of young disabled adults. Each year an average of thirty persons graduate from the institution but only a small number have been successful in finding jobs.

More recently an information technology training programme has been introduced with a view to preparing persons for jobs in the developing Information Technology sector.

Employment

Employment is a major area of concern for persons with disabilities as only a few persons have been able to secure jobs. A number of factors contribute to this, such as lack of training and inaccessible buildings and accommodation on the job.

Access

The problem of access predominates throughout the region. If ramps are built for access the interior of buildings are still inaccessible so the presence of a ramp is not a true indication of accessibility. In Jamaica a draft of the amended building code is under review for a number of years. Access for hearing impaired persons is still limited also the production of alternate material for the blind.

Other aspects of the programme are being implemented by the various governmental and non-governmental organizations.

Next steps

Although many persons are not aware of the formal UN programme there is heightened awareness to the extent that various aspects of the programme are being carried out in many countries by both government and non-governmental organizations. How do we evaluate progress being achieved towards the programme policy goals and objectives? What is required now is information to assess the current situation. There is the need to establish a set of indicators to compare the situation of persons with disabilities which will help to determine the priorities for the future.

The need for data for planning and implementation as well as evaluation cannot be over emphasized. The 1991 census provided baseline data and the 2000 round is in progress so we have not had the opportunity to make comparisons of the data. The data from the census however is not accepted by the disability community, which thinks that the number is understated. In light of this there is the need for up to date registers to supplement the data. There is also the need for surveys as well as standard measures to allow for comparison of the data.

The next priorities should be in the following areas.

  • A coordinated approach is required towards the implementation of the World Programme of Action.
  • Countries should develop national policies with the corresponding legislation where it does not exist.
  • The new WHO classification and definitions need to be disseminated widely to Statisticians, NGO's and researchers .
  • There is need for Sample surveys-quantitative and qualitative analyses. especially during inter-censal periods
  • There is need for public education
  • Funding resources for developing programmes and the strengthening of disability organizations

Bibliography

United Nations (1983) World Programme of Action concerning Disabled Persons.
Marigold J. Thorburn
Kofi Marfo
Practical Approaches to childhood Disabilities in Developing Countries.
Ministry of Labour & Social Security (Jamaica) National Policy for Persons with Disabilities (November 2000).

* The views expressed are those of the author and do not necessarily represent those of the United Nations Secretariat. This document has not been formally edited.

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