2010 Ramon Magsaysay Awardee A.H.M. Noman Khan, Executive Director of Bangladesh’s Center for Disability in Development (CDD) tackled disability with a unique twin-strategy they called Community Approaches to Handicap in Development (CAHD). Through his work, disabled people in Bangladesh can stand tall and proud.
Enduring stares without the perks of celebrity is a typical aggravation of the disabled. The poorest of the poor are actually the disabled among the world’s “ultra poor”. Problems of the disabled sector in the developing world reflect and magnify the same problems of development for any Third World economy. The same problems of lack of resources and structural obstacles bedevil the disabled sector, except that few believe in returns from funneling help to the disabled. Programs of assistance may not even exist for a sector seen as incapable of contributing to society. There is no profit bottom line in sight.
To say therefore that “disability is not a burden” is a heroic statement. But this is just what Norman Khan asserted when he organized the Centre for Disability in Development in Bangladesh way back in 1996. The baseline was misery. Even in the most enlightened and urbanized societies of Southeast Asia and the Subcontinent, the physically and mentally impaired are in turns taunted, avoided, ignored. They are the object of prejudice, victims of neglect, and worse, sexual assault. Symptomatic of society’s attitude is that the official population census of disabled is often understated, because they are often not counted. On paper at least, they can perhaps be made to disappear.
Concerns with the disabled closely relate to the poverty issue because first, the disabled in impoverished economies commonly do not work, making no input to GNP. Secondly, their care takes up resources and worse, removes at least one family member from the labor force. In effect, this is an increase in consumption without compensating addition to productive output. It is roughly estimated that for every disabled person, four to five other family members are affected. There is little education to train the disabled to help themselves. Even their caregivers lack the basic skills needed to perform supportive care. Few people with impairments can afford assistive devices like canes, braces, prosthetic devices, and wheelchairs. Dimly viewed as sapping GNP, the disabled have often been sidelined in economic activity. They are consigned to dependence on episodic manifestations of charity.
To Noman Khan and his associates, what was evident was the other side of the coin—that for these selfsame reasons, the disabled are an integral part of development.
Such was the dismal scene until Noman Khan turned things on their head. He saw the disabled as assets, not parasites. To fully realize their value, they had to be meshed into the fabric of nation-building. His thesis is that the disabled can be productive and as such, be successfully mainstreamed in society. The shift in mindset meant recognizing disability not as hindrance to development, but as active elements in cross-cutting development issues. Their abilities had to be developed. Forthwith, Khan left the policy and planning sphere of government to organize an NGO that would make his vision come true.
In 27 November 1996, AHM Norman Khan formally organized the Center for Disability in Development (CDD). The Centre was established to promote understanding of disability issues, and to serve as resource organization for building the service delivery capacity of existing GOs and NGOs. CDD’s work focus was to lay a strategy to realize this vision through “community-based rehabilitation” (CBR). The mechanism to implement CBR would be “Community Approaches to Handicap in Development “ (CAHD).
Scope for Intervention
CDD scanned the environment and the ground to be cultivated. To start with, three things needed to be changed: attitudes and the social environment, the incidence of disability, and lack of services for the impaired. Activities to effect such changes had
to be designed. The CAHD therefore has four components for effecting interventions envisioned to catalyze change:
1. Social communication – providing knowledge about causes of disability,the roles of family members and organizations, the prevention of disability, and rehabilitation practices;
2. Inclusion and rights – ensuring inclusion and participation in social and economic life, and equal access to opportunities as citizens;
3. Rehabilitation (Therapeutic Interventions) – helping the disabled develop skills
4. Management – organizing, monitoring, and controlling the elements of the three aforementioned activities to ensure that these remain relevant, efficient, and effective.
Intervention activities must be carried out through three sectors surrounding the disabled: Primary ( the core environment of family and where the disabled lives), radiating out to the Secondary sector (the first macro-level environment of organizations, trade, commerce, and governance), and farther out to the Tertiary level (the second macro-level of organizations, trade, commerce, and governance). CAHD is in this tertiary sector of the CAHD implementation scheme.
The Implementation Framework
Aspects of CAHD’s implementation framework are Organization, Process, and Documentation.
Organization: Key to managing work of widespread scope is organization. CAHD harnesses the involvement of the CAHD network and organizations that do initiating, implementing, research, and referral.
Process: There is a roadmap to implementing CAHD. Steps along the route are:
1. Starting the development of CAHD by an initiating organization;
2. Conducting a situational analysis;
3. Developing training capacity;
4. Developing CAHD in implementing organizations;
5. Implementing social communication;
6. Including disabled persons in family and social activities;
7. Including disabled persons and their families in development activities;
8. Including disabled persons in secondary and tertiary sector organizations;
9. Providing rehabilitation and referral services;
10. Developing a network in the secondary and tertiary sectors;
11. Including beneficiaries in the monitoring process;
12. Establishing a reporting and information-sharing system.
Documentation: In its operations, an organization such as the CDD documents its findings and learnings from its experiences. This has facilitated the production of information and training materials, aside from their dissemination.
Tools of Intervention
Interventions are designed to address the situation in each area, using such tools as training, technology, partnerships and networking, and programs. The goal of CDD’s training is to build organizational capacity in a) development, implementation, and
management of activities addressing disability issues; b) creation of awareness, positive attitudes, and a disability-friendly environment, and c) provision of primary therapeutic services and establishment of referral links. The courses include CAHD Orientation, Social Communication in Handicap and Disability, and Community Handicap and Disability Resource Person Training.
Before and After
Now, after a decade and a half of CDD operations in Bangladesh, about 300 organizations are working on disability issues, and over 200 organizations are implementing CAHD. The range of programs designed to empower the disabled has bloomed to include microfinance and self-employment/livelihood. Beneficiaries
now include the autistic, the deaf-mute, and those with multiple disabilities. Today, the disabled of Bangladesh can look back to a long, difficult road traversed, the pathetic baseline left far behind, a distant point of departure towards a better life.
The question now is, could the achievements of the CDD and Noman Khan have happened elsewhere? The Bengalis who founded the nation are known to be a clever genius race, of which Nobel Prize-winner Rabindranath Tagore is the prime example.
Could the CDD model be transplanted successfully? The answer is a resounding Yes. CDD’s template for working with the disabled has been adopted in other countries, including the Philippines, with positive results.
Khan has said: “Disabled people have dreams…All they need is the proper environment to work in, the resources enabling them to move around and have access to lead a normal life.” To surmount difficulties towards making one’s own dream a reality, is human achievement. To take another’s hand to help him realize his dream is a laudable triumph of the human spirit. The Ramon Magsaysay Award bestowed on AHM Noman Khan is a fitting laurel.