Poverty and Disability The Case in Bangladesh

by Md Nurul Abedin

BANGLADESH is a poor country judged in the context of all indicators viz. per capita income (US$ 386) GDP growth rate (5.5%), rate of unemployment (24%), incidence of absolute poverty (40%) and number of people living below the poverty line (48% in rural areas). Poverty, in the context of Bangladesh, is usually defined as the inability to attain a minimal standard of living. Failure to attain that standard means the negation of required calorie intake, nutritious food, health care, educational opportunities, safe drinking water, proper sanitation and shelter to the vast multitude of people with consequent adverse effect on their productivity, national growth process and social equilibrium. Based on the realisation that the nation cannot reap the good harvest of development efforts leaving large number of people in the womb of poverty, its alleviation has been accepted as the core of State Policy right from the inception of the country as an independent sovereign state.


Bangladesh is not only a poor but a populous country as well. According to the census of 1991, the country is now inhabited by more than 12 crore people. WHO (World Health Organisation) has estimated that 10 per cent of the country's population (i.e. 1 cr. 20 lac) is disabled. Some local surveys suggest that as high as 14 per cent of those surveyed are disabled. Even within this 10 per cent, the number of children and youths aged upto 16 years is about 60 lakh. Seventy per cent of the disabled population is totally illiterate. Annually an approximate number of 2,50,000 of the disabled join the mainstream of population. Every year about 30 thousand children aged less than six years lose their eye sight and hearing power due to malnutrition and Vitamin 'A' deficiency. In other words, about 100 children per day and four per hour are falling victims to this kind of disability. About 10 lakh children in the same age group (aged less than 6 years) are suffering from the symptoms of blindness due to nutrition deficiency. Every year, in Bangladesh, about 1,80,000 to 3,25,000 pregnant women suffer from the disease of night blindness due to vitamin 'A' deficiency. Apart from these factors, people also fall victims to different kinds of disabilities due to deformity at birth, diseases, flood, cyclone, tornado and rail/road/air accidents.

From the above analysis, we can come to the conclusion that disability is caused by the interplay of either natural or accidental or health factors. Whatever may be the factors, the fact remains that disability is characterised both as a cause and effect of poverty. There is general belief that a disabled person loses his/her working ability and, as such, productivity. Because of this societal belief, he/she is pushed aside the mainstream of productive activities and, as a consequence, remains in the realm of abject poverty. The poverty does not permit him/her to have access to health care, nutritious food, education and training. Had not the poverty prevented his/her access to these services, his/her disability would have been mitigated to a large extent. There is, now-a-days, a growing global realisation of the existence of an intrinsic relationship between disability and poverty.

With this strong hypothesis, the Impact Foundation, Bangladesh (IFB) conducted a survey in four thanas (sub-district) of Chuadanga district in April, 1997 to work out the strategy for the implementation of "The Comprehensive Primary Health Care Project for Prevention and Care of Avoidable Disability". The survey established a strong relationship between poverty and disability and between prevention of disability and alleviation of poverty. The survey has brought out certain interesting findings. Some of the findings which are of interest to us are:-

(a) 61 per cent of the total disabled persons are identified with 0 to 0.49 acres of land-holding, taken as a measure of the level of poverty.

(b) 20 per cent of the total disabled persons are located in households with 0.50 to 2.99 acres of land. Thus as the amount of land-holding increases, the rate of disability decreases.

(c) 19 per cent of the total disabled persons are located in households with 3 and above acres of land-holding.

The above findings reveal an inverse relationship between the source of income (land-holding in this particular case) and disability. As the source of income increases, disability decreases. When the source of income decreases, disability increases. Decrease in the sources of income means loss of purchasing power. This phenomenon negates a person's access to better health care, education, shelter, nutritious food etc. Faced with the denial of such social security, a person tends to become morbid, morose, melancholy, mentally-depressed and physically uncared for which, in turn, accentuate his/her disability.

Disability syndrome is further aggravated by social taboo. Our society still does not accept a naturally born disabled baby with the same amount of fanfare as it does in case of the birth of a normal baby. Concern appears to be writ large on the faces of parents and other near relations. From the very moment of such baby's arrival in this world, he or she is considered to be a liability rather than an asset. Seldom we realise that such a baby has no control over his/her birth. Rather the callousness of the parents is to be blamed. Had the proper health care and nutritional needs of would-be mother been taken during the period of her pregnancy, the fate of new-born disabled baby would have been different and he or she would have appeared in this planet like other normal human babies. This observation also holds good in case of accidents. Accidents are not the own-making of the disabled persons. Normal and able persons fall victims to accidents much against their will and as such, become disabled due to the follies of others - persons and agencies alike. Why should such a person suffer in perpetuity for a happening which is not his or her own creation? Has not the society, the state and the humanity at large anything to do to wipe out their suffering and rehabilitate them as normal human beings in God's universe?

The answer to this question is an emphatic 'Yes'. The panacea lies in their rehabilitation in society as productive force. Realisation should be all-around that they are not only the consumers but the producers as well. Consumers simply take away from the productive process but the producers add to it and thereby contribute to the growth of societal wealth. Part of the society as they are, they also grow as the society grows - thereby alleviating their poverty. But the big question is how to transform the disabled persons into productive forces of the society? The simple answer is "by way of human resources development" (HRD). Not less than 50 NGOs and different government agencies are now working for rendering services to the disabled including training for the development of their latent faculties. Notable among them are Special Education Centre at Mirpur, Centre for the Rehabilitation of Physically Handicapped (CRPH) at Savar and Employment and Rehabilitation Centre for Physically Handicapped (ERCPH) at Tongi with the attachment of "Moitry" industry. Different disability-related societies and also their federation NFOWD (National Forum of Organisations Working with the Disabled) are also conducting training programmes for the disabled from time to time. Three programmes - Rural Social Services (RSS), Rural Mothers' Club (RMC) and Urban Community Development (UCD) - are now under implementation by the Directorate of Social Services (DSS) These have poverty alleviation connotations (income generation and employment creation) for their beneficiaries.

New strategy such as CBR - Community-based Rehabilitation - is also picking up momentum for induction of PWDs (people with disabilities) in the mainstream programmes of health, education, rural and tribal development, urban poverty alleviation and so on to enable them to lead a life with dignity without getting disintegrated from the families and communities. The Dhaka Declaration made at the conclusion of the Second South Asian Conference of the CBR network held in Dhaka from 3 to 6 December, 1997 urged the government and non-government authorities of South Asian countries to develop access of all people with disabilities to basic rehabilitation services by the year 2010. GOB has also made increased allocation for social welfare sector over the plan periods - starting from the first five-year plan (1973-78) up to 5th five-year plan (1997-2002).

What is the impact of all these arrangements on the disabled? Has there been any impact study by any authority? At least, I am not aware of. But I am very much concerned at the magnitude of the problem as is evident from the statistical pocket book for 1998 published by Bangladesh Bureau of Statistics (BBS). It has shown that 11.98 persons say 12 persons per thousand people in Bangladesh suffer from one kind of disability or the other and are subject to abject poverty. We cannot expect peace, social justice and development in the country leaving this vast multitude of people under the shades of poverty. Work plans for the alleviation of their poverty are to be chalked out for implementation by the public and private sectors alike. The plan should encompass the following actions:

i) PWDS should be brought within the fold of micro-credit provided by the banking system and NGOs. NFOWD should prepare projects and present the same to the Employment Bank for financing the proposed economic activities of PWDS. NGOs should also be propelled to provide micro-credit to the PWDS. During the tenure of my office as MD, PKSF, I have noticed the inertia among the NGOs to advance such credits to the PWDS for fear of its non-refund by PWDS because of the alleged lack of their working abilities.

This myth of the NGOs is to be broken by vigorous advocacy works to be undertaken by MOSW, DSS and NFOWD. PWDS are also to be organised under the umbrella of co-operatives. There are co-operatives of the peasants and even of the assetless. Why cannot there be co-operatives of the disabled? Ministry of Social Welfare (MOSW) should take the initiative for the purpose in consultation with the Rural Development and Co-operative Division. Many agencies including Bangladesh Rural Development Board (BRDB) will then come forward to provide the finance. There is usually no dearth of capital for a disciplined organised group.

ii) The concept of SAARC fund for disabled has been agreed to by the 10th SAARC Summit held in Colombo and found place in its declaration. Now the Ministry of Social Welfare, through the Ministry of Foreign Affairs, should urge upon the SAARC Secretariat at Kathmandu to initiate necessary action for the formal creation of the fund and its administration.

iii) All necessary measures need to be taken, without further loss of time, for the constitution of National Foundation For Development of the Disabled Persons (NFDDP) and utilisation of Tk. 15 crore earmarked in the current year's budget for the welfare of the disabled.

iv) Draft laws now under consideration in the Ministry of Law, Justice and Parliamentary Affairs, should be given fair shape without further delay to protect the rights of the disabled as enshrined in our constitution for all citizens.

v) Quotas, should be reserved for the disabled in the service of the Republic in line with quotas reserved for other groups.

vi) It should be made mandatory for the industries/factories, if necessary by legal means, to provide suitable jobs to the disabled in such establishments. Ministry of Social Welfare should take the initiative in holding talks in this respect with Ministry of Labour and Employment, FBCCI and Employers' Association of Bangladesh.

vii) Social security for the disabled should be there for their movement by whatever mode of transport they prefer as well as in all public places including the places of their work.

This is, by no means, an exhaustive list. The list can be enriched by induction of more points. I will say only this much in the conclusion that disabled persons are integral part of a civilised society and as such their latent potentials are to be harnessed for the development of the country. They can be turned into assets of the country if proper atmosphere congenial for their contribution to the development process can be created. Economists have defined poverty in different ways. I think the definition given by Prof. Amartya Sen, the noble laureate, is quite relevant so far as the disabled persons are concerned. He has defined poverty as "capability failure" in a given socio-economic structure. We cannot, hopelessly and helplessly, watch the capability failure of the disabled persons. We must swing into action to arrest their capability failure by arranging required training for then, organising them as coherent group and providing them with necessary capital. As a bird cannot fly with one of its wing closed so also a nation cannot fly in the realm of prosperity leaving a large chunk of its population in shambles of poverty. It is to be borne in mind that a hungry man is an angry man too. Unless his hunger is satisfied, words of morality will simply be turned a deaf ear to and he is likely to indulge in subversive activities to eke out his living and thereby threatening the social equilibrium.

The writer is a former Secretary to the Government of Bangladesh.

Source: The Daily Star, 24 May 2000