Chapter 2: An integrated approach to sustainable development for persons with disability
Why an Integrated Approach?
In the introduction, we talked about social prejudices against
disability. When these prejudices find their way into policies and practices of
government, they get institutionalised. In other words, the prejudices appear in
a new, more formidable form. They get cast in bricks and mortar. A building is
erected with the letters: "Rehabilitation Centre" for the blind, or for the
deaf, or for the physically or mentally disabled people.
This institutionalised prejudice, at a still higher level, could
take the form of a whole government ministry, or a department within a ministry,
set aside to look after the disabled people. With the poor, the aged, the
unemployed and other marginalised strata of society, the disabled people become
objects of "social welfare".
What we are advocating here is an integrated approach to
disability. In this chapter, we deal with "Integration" at the conceptual and
policy level; in another we deal with another expression of it, i.e. at the
community, or grassroots, level.
What does an Integrated Approach Imply?
It implies, first of all, that disabled persons must not be
treated as objects of social welfare. To be sure, there are those amongst them,
just as there are those amongst the able bodied, who may need support from the
state. Among these belong, the aged, the poor and the unemployed. There are
amongst the disabled people those whose disability may be so severe (such as
those with multiple disabilities) who would deserve state assistance. But this
does not) justify placing the whole category of people called "the disabled"
Secondly, it implies that insofar as disability is a social issue,
it should be the responsibility of the government cutting across particular
ministries. Disability is not the project just of the Ministry of Social
Welfare; that is the road to isolation. The integrated approach makes it the
responsibility of all ministries, just as it is the responsibility of all
ministries to be responsible for the environment, the rights of women and those
of the "abled" people.
Thirdly, integration means creating harmony, an attitude of
caring, within the families and the communities irrespective of whether their
individual members have disability or are able bodied. The disabled person must
be able to live and love like any other member of the family or the community.
And finally, integration means creating a space and an opportunity
for the people with disabilities to merge within the mainstream activities and
the general system of the society.
Of course, given the legacy of past policies and prejudices,
integration cannot be achieved overnight. Even with the best will in the world
to change things around, institutions stay in a state of transition for a long
time. But integration must be the objective of all those who are concerned with
the genuine welfare of people with disabilities.
What, Then, are the Barriers to Integration?
A barrier is like a fence or a hurdle. You have to jump it or go
around it in order to reach out to the other person. At the best of times, it
slows down communication; at worst it stops communication altogether. When
communication stops or is obstructed, the result is isolation. That isolation
reinforces the very prejudices which may have been the initial cause for
creating that barrier. If, furthermore, those isolated from the "mainstream" of
social and economic life are disabled for various reasons, this reinforces their
marginalisation and disempowerment. It is a vicious circle. The prejudice breeds
isolation; isolation further feeds into reinforcing the prejudice. Cutting off
from the mainstream of social and economic life marginalises those who are so
cut off, and marginalisation takes them further and further away from the
mainstream. This, in the days of apartheid South Africa, used to be
called "separate and unequal development", and, as we know, this cannot be a
lasting solution to any social problem.
What, then, are these barriers to integration that we must pull
down? The following is a schematic presentation of these barriers in the form of
a "continuum" [a "continuum" is an unbroken, or fluid, series of affairs that,
in this particular case, feed into one another; the series are connected, not
separate or isolated].
Nelson Isiko at the Entebbe Workshop: "I had 1, 000 friends,
and was left with only 7 when I lost my sight."
Barriers to Integration
Lack of self-esteem
Negative social attitude
Lack of opportunities to: e.g. employment education
Lack of access to resources
Infra- structural and architectural barriers
Legal and government policy & practice
The continuum is from the personal, the subjective, to the highest
institution of the state, namely the government. Lack of self-esteem is often
the product of the environment, including the manner in which the disabled
persons are brought up by the rest of the society. It remains the biggest
barrier to PWDs' advancement. Once that is restored (and this should be the only
legitimate use of the word "rehabilitate"), then half the battle is won. The
rest is a matter of mainstreaming integration.
What room is there for the institutional approach in this?
Historically, the presence of human beings with disabilities has
generated a slowly evolving response. It has moved from trying to eliminate
them, to the "poorhouse" approach (that is, removing them from the view of the
non-disabled people), to institutional care.1 In more recent years,
however, governments are closing down institutions because of budgetary
difficulties. That now is going to the other extreme.
Members of the Greenfields project.
(Photo by Marla Feldman)
Institutions are necessary, but they are necessary not as homes
but as back-up support to community and family efforts. And the approach within
the institutions must be applied not in a wholesale manner to all the people
with disabilities without regard to the specificity and gravity of each person.
Flexibility of approach that respects the dignity of the human being must at all
time be the cardinal principle of institutional intervention.
Types of Disabilities
Integration of Cross-Disabilities
There is another sense of integration that must be discussed,
namely the integration of people with different disabilities in common
activities. Institutional isolationist policies not only separate the PWDs from
the able bodied, but also the PWDs from one another based on their particular
disabilities. This is a further extension of the same policy of "social
These, like all categories, are "broad" categories, and hide real
differences that may exist within each category. For, of course, some are more
severely impaired than others within the same category, and these differences in
degree are as important to take into account in any programme as differences in
the type of disability. Once again, there is some justification for "transitory"
isolation of some forms of disabilities, or some training courses (e.g., to
learn braille). But this does not justify isolation as a matter of policy.
Now we come to the second phrase in the title of this chapter,
"sustainable development". "Development" has a positive echo, it evokes good
feeling. Everybody wants to "develop"; you cannot argue against it. And indeed
why should you? Is it not the right of every individual to want to better
himself or herself materially? Is this not what human existence is all about?
That is correct.
Because "development," as it has taken place over the last hundred
years or so has not been, and is not, "sustainable." Development cannot go on in
the manner it has all these years. What is taking place is backwards
development, perverse development, a disagreeable kind of development. In
fact, if the word is to mean something positive, something we can all support,
then it is not "development" at all.
According to a 1992 report by the International Food and
Agricultural Development (IFAD), called "Report on the State of World Rural
Poverty," the poor in the world have increased in number. Today, one person in
every five is "poor" in the sense that he or she does not have the means for
even basic subsistence. This is unprecedented in world history. In ages before
the "modern" epoch of industrialisation, people were indeed materially
"backward" when compared to the technological "advances" of our present times,
but, within the means available to them and barring natural catastrophe, people
in general had enough to "subsist." Today even this basic subsistence is eluding
over a billion of the world's five billion people. Poverty thus has
become the biggest issue on the world's agenda.
Next to poverty is Environment. Here, too, "development"
has brought catastrophe to our environment. Never before in history was the very
survival of the planetary ecosystem at stake. Today, humankind is destroying the
very basis of its own existence. If industrialisation continues apace in the way
it has done over the last 100 years, then within the next 100 years (or less) we
would be destroying the bulk of the world's forests, entire river systems of
large parts of the globe, the ecosystems that regulate the cycle of regeneration
of our natural resources, the fertility of the soil from which we derive our
foods, the purity of the air we breathe, the ozone layer that acts as a
protective shield against the sun's rays, and we would have exhausted most of
our non-renew able energy resources such as oil and natural gas, and most of the
minerals in the bowels of the earth.
Why, then, we might ask, is there actually a global movement
It is in this context that the concept of "Sustainable
Development" entered the calendar of global conferences. During 1987, some
of the leading citizens of our globe had decided that our present generation is
engaged in so much environmentally destructive consumption that the survival of
future generations is under serious threat unless "the needs of the present (are
met) without compromising the ability of the future generations to meet their
The delivery concept of "development"
But "development" has come to mean providing impoverished
communities with relief assistance, money for "income generating projects," and
material inputs to enable them to engage in production and marketing of
commodities for their survival. The "delivery" deal of development dominates the
work of most NGDOs in Africa. Development, in this instance, is defined as an
outcome of delivering to the "needy" masses certain cc things" - whether these
are actual material things (such as school books and blair toilets), or ideas
(in the form of "expert" advice, or technical assistance).
How do we react to this? For sure, the practical aspects of
"delivering" goods to people impoverished by the depressing condition of their
economies is important. This kind of help should by no means be devalued or
trivialised. But an exclusive preoccupation with these "bread and butter" issues
could lead to serious problems of which we should be aware.
Concentration on providing cc goods and services" gives us the
illusion that we are doing something to alleviate the poverty and
marginalisation of our people, whereas, in fact, we are doing all the running in
order to stay exactly where we are. Indeed we may be moving back wards. Why?
· Because we are not tackling the larger forces
that create poverty, unemployment and alienation among our people.
· Secondly, we would be avoiding our responsibility to think
through the workings of the larger system and leave all the thinking to be done
· Thirdly, the delivery concept disempowers people. It makes
people believe that their development is a product of receiving donor funding
from the North, and technical advice from their own or foreign
At the opening of the Entebbe Workshop, Hon. Eliphaz Mazima,
Member of Uganda's Constitution Assembly representing PWDs, quoted the former
President of Tanzania, Mwalimu Nyerere's definition of the term "development."
Mazima highlighted the following seven points about the definition:
· Development is a process;
· It is the realisation of potential for self support and
contribution to society;
· It involves the building of sell: confidence;
· It aims at leading lives of dignity which includes gainful
employment that helps individuals to meet basic needs, security, equity and
participation. These lead to fulfillment;
· Freedom from fear of want and exploitation; and
· Freedom from political economic and social exploitation;
· Development starts from within.
Development is a product of "struggle" by the people, not
"delivery" from the top
These seven points form the "ideological" glue that binds this
Guide. They need to be revisited from time to time. Unless development starts
"from within" nobody else is going to be bothered to do it for you.
A hen can sit on a stone and not produce a chicken. What
hatches into a chicken is the force of life inside the egg itself. The force of
change is inside oneself; outsiders can only provide "enabling conditions." No
[This is an adaptation from a quote by China's Mao
Entebbe Workshop participants visiting
the Greenfields Project, Mbale, Uganda. (Photo by Marla