18940_Insight-plus-towards-inclusive-education_Nusrat Zerin write up on Braille

Insight
PlusTowards inclusive
education
Issue 5 June 2012
www.sightsavers.org
©AndyWeekes/Sightsavers

www.sightsavers.org
Front cover photo:
Devilal enjoys learning alongside
sighted friends at his local school in
Rajhasthan
Contents
Foreword 2
Sunit Bagree
Early identification and stimulation as key factors in the
inclusion of visually impaired children in mainstream
schools in Belize 4
Joan Musa, Joan Samuels and Philip Hand
Demonstrating low vision services in Rajasthan 9
Nitin Sharma
Supporting Integrated Education in Sierra Leone 13
Tiangay Gondoe
Child Friendly Inclusive Education in Pakistan 17
Itfaq Khaliq Khan, Leena Ahmed and Ahmed Ghaznavi
The Right to Information: Addressing the reproductive
health needs of visually impaired adolescent girls 20
Jayashree Kumar and Monu Ravindran
Braille champions in Narshingdi district: the
experience of Sightsavers Bangladesh 25
Nusrat Zerin
What lessons can we learn from our experiences? 29
Guy Le Fanu

From the editor
Claire Jago, Learning Support Officer
Welcome to the fifth
issue of Insight Plus,
Sightsavers’ bi-annual
learning review.
Working with partners across Africa, Asia and the
Caribbean, Sightsavers’ aim is to eliminate avoidable
blindness and promote equality of opportunity for
disabled people. This series collates learning and best
practice from across our programmes, with each issue
focusing on a different thematic area.
In this issue, we focus on education and how
Sightsavers and our partners are working to ensure that
all disabled children have the opportunity to receive
a quality education within a wider education system.
The featured articles cover a diverse range of topics,
such as promoting inclusion through early childhood
intervention in Belize, empowering local Braille
champions to support visually impaired children in
Bangladesh, and educating visually impaired adolescent
girls about their reproductive health needs and rights in
North India.
I hope you find Insight Plus useful, and welcome your
comments and suggestions. Please send your feedback
to learning@sightsavers.org
Sightsavers
Grosvenor Hall
Bolnore Road
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West Sussex
RH16 4BX
UK
Tel: +44 (0) 1444 446600
Fax: +44 (0) 1444 446688
www.sightsavers.org
Copyright
Any Insight Plus material may be
freely reproduced, provided that
acknowledgement is given to
Sightsavers as the author.
ISSN 2044-4338

www.sightsavers.orgPage 2
There is undoubtedly a lack of quality global
data on disability in education. However,
we do know that being disabled more than
doubles the chance of never enrolling
in school in some countries; it is often a
more significant factor when it comes to
exclusion from education than gender or
geographical location.1
Moreover, there is a
clear relationship between poverty, disability
and access to education. For example, having
a disabled parent who is poor increases the
likelihood of seven to sixteen year olds never
having been to school by 25 percent in the
Philippines and 13 percent in Uganda.2
The Convention on the Rights of Persons with
Disabilities (2006)3
is a landmark international
human rights instrument for disabled people.
Article 24 of the Convention commits
state parties to ensure that ‘persons with
disabilities can access an inclusive, quality
and free primary education and secondary
education on an equal basis with others in
the communities in which they live’. Article 32
places an obligation on donor governments
to make their support ‘inclusive of and
accessible to persons with disabilities’. Yet,
as an important study published last year
argues, ‘… donors continue to fail when it
comes to honouring their pledges to protect
and maintain the rights of disabled children…
a deep gap exists between the rhetoric of
inclusion and the reality of implementation,
Foreword
Sunit Bagree, Policy Advisor: Education
Sunit Bagree
©Sightsavers

and between the international policies
and practices of donors around inclusive
education’.4
One key problem is that donors do not appear
to consider disabled children (and adults)
as a priority when tackling marginalisation in
education. The main focus of donors is on
improving access and quality for girls and
children in fragile states. While both of these
groups make up a large number of the world’s
children who are not enrolled in school or
learning effectively, they certainly do not
represent all of the excluded. Donors need
to work with national governments to adopt a
more comprehensive - rather than fragmented
- approach to equity and inclusion.
Another major problem is that donors are
failing to dedicate adequate resources to
basic education in general. Donors only
allocate 4.1 percent of their aid to basic
education when the international benchmark
is 10 percent.5
If donors dedicated 0.7 percent
of GNP to aid (in line with an international
agreement dating back to 1970) and met the
10 percent benchmark, an additional US$21
billion would be generated annually.6
As long
as principles of aid effectiveness and policy
coherence for development were respected
and applied, this level of financing would
be sufficient to meet the Education for All
goals and lay a strong platform for achieving
education rights more broadly.
At the global level, Sightsavers is calling on
donors to:7
v
Develop strong targets for including
disabled children in education (in terms of
both access and quality).
v
Dedicate adequate financing to achieving
these targets.
v
Use guidelines/tools for inclusion when
planning and monitoring education
programmes, to improve access and quality
for disabled children.
v
Support disabled people’s organisation
to develop their capacities to genuinely
engage in education sector planning and
reviews.
v
Report on progress in a transparent manner.
Of course, advocacy is central to programme
work. As some of the following articles
demonstrate, this can take different forms:
encouraging the government to scale up and
transfer examples of good practice (e.g. North
West India); building the capacities of civil
society groups to combat discrimination (e.g.
Sierra Leone); and influencing policy change
(e.g. Pakistan). In turn, these activities serve to
strengthen Sightsavers’ legitimacy and profile
at the international level.
1
Filmer, D. (2008) Disability, Poverty, and Schooling in Developing Countries: Results from 14 Household Surveys,
http://siteresources.worldbank.org/DISABILITY/Resources/280658-1239044853210/5995073-1246917324202/
Disability_Poverty_and_Schooling_in_Developing_Countries.pdf, p. 141.
2
UNESCO (2010) EFA Global Monitoring Report 2010, http://www.unesco.org/new/en/education/themes/leading-
the-internationalagenda/efareport/reports/2010-marginalization/, p. 184.
3
See http://www.un.org/disabilities/default.asp?id=150.
4
Lei, P. & Myers, J. (2011) ‘Making the grade? A review of donor commitment and action on inclusive education for
disabled children’, International Journal of Inclusive Education, 15, 1169-1185, p. 1183.
5
Global Campaign for Education (2011) Fund the Future - Education Rights Now, http://www.campaignforeducation.
org/docs/reports/ftf/Fund%20the%20future_education%20rights%20now.pdf, p. 3.
6
Ibid, p. 8.
7
For more detailed recommendations, see: Myers, J. & Bagree, S. (2011) Making inclusive education a reality, http://
www.sightsavers.org/in_depth/policy_and_research/education/16079_Sightsavers%20IE%20Policy%20Paper%20
2011%20-%20FINAL.pdf.

So, with his father’s help, Rowan completed
the steepest portion of the climb and emerged
from the trees to feel the wind in his face,
knowing that, because of his bravery and
selflessness, all the children would be able to
attend Camp.
Born in 1998, Rowan is the first child, blind
from birth, which BCVI has supported through
early stimulation and primary school. This year
Rowan took his Primary School Examination
and will go on to high school. In addition to
being a very articulate spokesperson for BCVI
as their ‘Ambassador for Sight’, Rowan is an A
student excelling in all subjects. His success
can be attributed to the cooperation and
support of his family, Hummingbird Elementary
School, and BCVI.
Early identification and stimulation
as key factors in the inclusion
of visually impaired children in
mainstream schools in Belize
Joan Musa, Executive Director, BCVI
Joan Samuels, Rehabilitation Coordinator, BCVI
Philip Hand, Programme Manager, Sightsavers
©BCVI/Sightsavers
Rowan Garel, BCVI’s Ambassador for Sight, meets Prince Harry
When a lack of funding threatened the Belize Council for the Visually Impaired
(BCVI) 2011 Summer Camp for visually impaired children, 12 year old Rowan Garel,
who has been blind since birth, took up the fundraising challenge by scaling the
heights of Victoria Peak. Making his way to the summit of the highest mountain in
Belize, with his legs trembling and breathless after two days hiking, he thought ‘I’m
never going to make it’. But his thoughts turned to the other blind children who
look forward to the annual Summer Camps and he realised, ‘If I only come this far,
I’ll just be known as the boy who tried and couldn’t.’

Introduction
Sightsavers’ partner, BCVI, was established in
1981 and works hard to meet the eye health
needs of the country’s 345,000 inhabitants,
while also advocating for the rights of all
visually impaired people to lead independent
and fulfilling lives.
BCVI believes it is essential to identify a visually
impaired person as early as possible, whether
it is a young child, an adolescent, or an adult
who has experienced recent loss of sight. This
enables children to attain developmental and
educational milestones and, for all individuals,
the early introduction of rehabilitation and
education services contributes greatly to a
higher level of achievement.
BCVI’s approach
BCVI promotes a Life Cycle Approach and
has supported many people who are visually
impaired from birth through school, university
and employment. BCVI supports older people
through initiatives like the Visually Impaired
Club which enables older people to socialise
and be active members of society. BCVI
believes that education is the key to human,
social and economic development and that it is
a fundamental human right. Inclusive education
provides the best opportunities for children
who are visually impaired.
In 1989, the first children to be placed in
mainstream education in Belize were three
students then attending the residential school
for children with disabilities in Belize City.
Two of the students were from outside Belize
district so they continued to reside there while
attending a nearby primary school. After two
years, they returned home to live with their
families and attend their local primary school.
Shortly after, two children with severe low
vision were introduced to a mainstream school
and functioned well with the appropriate aids.
This pattern of inclusion has continued
from there and BCVI’s approach, coverage
and commitment has led to 100 percent
identification and placement of children
who are visually impaired in the mainstream
education system.
How children are found
BCVI’s Comprehensive Eye Care Programme
is structured in a way that greatly improves the
chances of early identification of children with
visual impairment. Identification takes place
through district based primary eye clinics,
outreach activities, involvement with the public
and private school system, public awareness
activities, and continuous engagement with
communities throughout the country.
Each aspect of BCVI’s comprehensive
programme is linked, so no matter where
a child is identified they can be referred,
professionally assessed, and introduced to
the most appropriate service(s). If children
are thought to have vision related problems,
it is only a matter of time before BCVI makes
contact and begins working with children,
parents, teachers, community members and
health professionals to ensure development
and inclusion.
All children are professionally assessed and
those who cannot reach a functional visual
acuity with refraction by an optometrist are
referred to an ophthalmologist for confirmation
of a diagnosis and exploration of treatment
options. This stage also includes a low vision
assessment which is performed by one of
BCVI’s optometrists with specialist training.
The assessment is done in cooperation with
a BCVI Rehabilitation Field Officer (RFO), who
will have made an assessment of the home
and school environment. Children with low
vision are provided with aids and, if they have
sufficient vision to be able to function with print
material, only need occasional support visits
from BCVI’s RFO.
What happens in early
stimulation?
Once a child is introduced as a client to BCVI,
staff members begin to encourage him or her
through activities and play which help build
confidence and an awareness of the world
around them. For children up to five years old,
this takes place as part of the early stimulation
programme which began in 1994 as a
collaboration with Hilton Perkins International.
One of the objectives of the programme is
to prepare babies with the capacities which
will eventually enable them to become
included within the regular school system
at the same age as their sighted peers. The
programme began by carrying out a series
of one week workshops to sensitise and
build the confidence of parents of visually
impaired children under five. The workshops
gave parents an idea of the skills their
children would eventually have to learn (Braille
reading and writing, abacus, cubarithm slate

and cubes, computer skills, orientation and
mobility, and independent life skills) and also
introduced them to other parents with young
children who are visually impaired. BCVI no
longer runs these workshops, but instead
uses an annual Summer Camp as a means of
providing training to parents.
In supporting a visually impaired child, the first
step at individual / family level is to assess
the family’s situation in a holistic manner. This
assessment focuses on six key areas; spiritual,
emotional, physical, financial, social and
aesthetic. Should any issues be identified in
any of these areas, they are addressed through
referral to the appropriate community agency.
An Individualised Rehabilitation Plan (IRP) is
then drawn up in consultation with parents.
This is based on the child’s ability and level of
performance as laid out in the Oregon Project1
or the Portage Guide2
. A copy of the IRP is
used by the BCVI RFO and another is used by
the parent or caregiver. One-on-one training
is carried out to ensure that the caregiver
or parent understands their role, the goals
and the time frame within which activities are
expected to be achieved. The RFO ensures
that parents and caregivers are provided with
relevant training materials, and also carries out
support visits to the home.
An example of an activity and related goal is
preparing the child to learn and recognise the
Braille alphabet at three years. To achieve this,
a Braille book is made from small buttons in
the shape of the Braille alphabet. The Braille
alphabet is then introduced in groups of five
letters starting with A to E and continuing until
the child is fully competent. A similar exercise
is done for learning numbers using sticks,
stones, limes etc.
1
http://www.soesd.k12.or.us/SectionIndex.asp?SectionID=132
2
http://www.portageproject.org/dev/npg/index2.htm
Courtenay Gillett participating in a computer session at Easter camp
©Sightsavers
Courtney Gillett is nine years old and attends Christiline Gill Primary School in Corozal
Town, where she is in grade Standard Four. The photo shows Courtney participating in
a computer session at a BCVI Easter Camp. She attends camp with her grandmother,
who fights Courtney’s cause every step of the way.

From early stimulation to
pre-school and primary
Children in Belize attend pre-school from three
to five years of age. These two years are of
vital importance in acquiring early childhood
learning skills and preparing for primary
school. Early childhood learning is available
nationwide and almost every public school
has a pre-school attached. Children with visual
impairment have full access to this learning
opportunity, but children whose primary
disability is not vision related do not have the
same level of opportunity. Those who cannot
function in the regular pre-school setting are
referred to the National Resource Center for
Inclusive Education (NaRCIE) or CARE Belize
for intervention services.
At pre-school level, the RFO supports
parents to register children in a pre-school
of their choice. The RFO also develops an
Individualised Education Plan (IEP) with
parents and teachers, carries out teacher
training and support visits, and ensures
provision of educational materials and
appropriate technologies.
At primary level, RFOs should ideally provide
Curriculum Plus Skills training to Itinerant
Resource Officers from NaRCIE, to ensure
that they can provide support for teachers with
visually impaired students in the classroom.
While this has happened in the past, NaRCIE’s
current limitations would make this training a
waste of scarce resources.
The role of the Summer Camp
Since its inception in 1997, BCVI has hosted
an annual Summer Camp for children who are
visually impaired and their parents and family
members. The Camp, which lasts two weeks,
provides opportunities for professionals to
assess the progress of children and teach
them special skills, and for all participants to
socialise and have fun.
Up to 30 visually impaired children attend camp,
accompanied by a guardian if they are under
15 years old. In recent years, themes have
included ‘Exploring Technology’, ‘Inclusion’,
and ‘Exploring the World through Reading’.
Camp activities are designed to ensure children
prepare for their new school year and to
introduce new Curriculum Plus Skills.
Children also get the opportunity to enjoy new
experiences like over-nighting at the Tropical
Education Centre, going to the movies and
working with local artists. Children have also
visited Love FM TV and radio studios where
they took the opportunity to show the nation
that nothing is holding them back.
Summer Camp has proven to be a key activity
in the educational and social development of
visually impaired children and their families. In
response to this, BCVI introduced New Year
and Easter Camps in 2012; these are three
days long and focus on introducing technology
to older children.
Overcoming challenges to
delivering and maintaining
services
While BCVI has developed an effective
system for early identification, a quality early
stimulation programme, and access to an
inclusive education system from pre-school
onwards, there are still a number of challenges
to overcome:
v
Education of children with visual impairment
or other disabilities is not a self-sustaining
activity. Government funds and resources
are extremely limited and BCVI continuously
needs to source funding to ensure that
each child has an equal opportunity. In 2011,
BCVI provided support to 11 infants in early
stimulation, 51 students in mainstream pre-
school, primary and secondary education,
and three children with multiple disabilities
in a special education unit. A rough average
cost for BCVI per child per year is BZ$1,445
(US$723).
v
Although NaRCIE are the Government’s
inclusive education coordinating body, BCVI
carries the entire workload of supporting
children who are visually impaired in pre-
schools, except for occasional visits by
NaRCIE’s Itinerant Resource Officers.
BCVI’s advocacy has not been successful
in changing this situation, but they are now
working with parents and families of children
with visual impairment, so that they can lead
on advocating for improved support and
services from the Government.
v
Summer Camp has proven to be a very
successful initiative which provides support
for children and their families as they enter
into new phases in their education. Summer
Camp depends largely on the support of
community organisations and the private
sector. This support has dropped off in

recent years as the economy of the country
has contracted. BCVI has been fortunate
that Rowan Garel, one of the children they
supported throughout his education, has
become the lead fundraiser for this event
and his efforts in 2011 not only generated
enough resources for Summer Camp, but
also contributed to the educational support
of other children with visual impairments.
v
Like most children, children who are
visually impaired want better access to new
technologies, both in the classroom and at
home. Keeping up with new technologies,
making them available, and ensuring
teachers can optimise their use are
ongoing challenges which BCVI is working
to address, with support from its partners.
However, relative geographical isolation
does limit access to new trends regionally
and internationally.
v
Children with visual impairment have
a better degree of access to inclusive
education services than children with other
disabilities, but neither the Government,
BCVI, nor other NGOs are in a position to
bring about the required change at present
or in the immediate future.
Conclusion
Belize is unique in many ways and not many
countries can say that all children who are
visually impaired are in mainstream education.
The commitment of BCVI, combined with the
contributions of children, parents and teachers,
will ensure that quality inclusive education
for children with visual impairment remains
possible. However, it will take a greater effort
by government and non-government agencies
to ensure this life-changing opportunity and
fundamental human right is as widely available
to children with other or multiple disabilities.
Maria Cal using a cubarithim board during a maths
session
©Sightsavers
Maria Cal is five years old and attends
Infant One at Peter Claver Primary School
in Punta Gorda Town, Toledo. The photo
shows her using a cubarithim board in
a maths session. Maria attended camp
with her mother, who is in her final year
of teacher training, having changed from
business studies in order to support her
daughter. She also attends Joan Samuel’s
RFO training sessions and is a great
example of parental commitment and
dedication.

Demonstrating low vision services
in Rajasthan
Nitin Sharma, Programme Officer, North West India
©LauraCrow/Sightsavers
Satyanarayan studies with his friends
Satyanarayan is doing well in school. He participates in a full range of school
activities and particularly enjoys reading articles from the newspaper to his
friends. However, a year ago the story was very different; Satyanarayan was having
difficulties reading textbooks due to the small print size and could only read the
headlines in newspapers. At school, he depended on just listening to the teacher
in class. Satyanarayan was then brought to a low vision assessment camp held in
Bikaner, where he received training on the use of Dome (an optical magnification
device) and was provided with a pair of spectacles. Today, there are hundreds
of children in Rajasthan who similarly enjoy learning because they have been
provided with a small device, costing only around £10.
Introduction
Unfortunately, the scenario is not the same
for all children with low vision. Although much
can be done to enhance the vision of people
with low vision, they often do not receive
the appropriate services and support they
require to complete their education and fulfil
their potential. Special educators trained in
supporting blind children find it difficult to help
children with low vision, as teaching skills in
Braille and the use of tactile materials are not
appropriate. Optometrists sometimes lack the
skills and resources to provide high quality
assessments and assistance for children with
low vision. And, in the worst case, children

with low vision are not identified due to poor
awareness among service providers.
In Rajasthan, Sightsavers is working in close
association with the Government to remedy
this situation. In particular, we are working
through the Government’s Sarve Shiksha
Abhiyan (SSA) programme which promotes
Education for All.
Our approach
Sightsavers North West India has been
supporting the education of visually impaired
children in the state of Rajasthan since 2001.
Over 300 children have been supported and
many of them have successfully completed
their school education. However, Sightsavers’
support was limited to a few districts within the
state. In other districts, the education provision
for children with visual impairment was poor
and in general there were gaps in policy and
implementation at the government level.
In 2008, Sightsavers developed a new five year
strategic framework which placed increased
emphasis on strengthening government
systems. Consequently, Sightsavers North
West India shifted its focus from service
delivery to systems strengthening and
advocacy. A situational analysis of the needs
and priorities for inclusive education was
undertaken in 2008, with the support of the
Blind People’s Association, and this study
strongly highlighted the current gaps and
potential opportunities to strengthen education
systems for a positive change. Building on
this situational analysis, efforts were made
by Sightsavers to establish good rapport with
state level officials in Rajasthan and to support
capacity building initiatives such as the training
of resource teachers. This collaboration
led to increased Government confidence
in Sightsavers and, having increased our
credibility and gained recognition as a
technical resource agency, Sightsavers was
invited by the State Government to enter a
formal partnership around education.
The Government of Rajasthan signed a
Memorandum of Understanding (MOU) with
Sightsavers to run a pilot inclusive education
project in two districts, covering over 600
children. The MOU focused on activities such
as the demonstration of low vision assessment
approaches, state level planning, and support
to capacity building initiatives across all 33
districts within the state. This is the first MOU
between the Government of Rajasthan and any
civil society organisation under a public private
partnership for inclusive education.
The pilot project
The primary objective of organising low
vision assessment camps on a pilot basis
was to give exposure to district level teams
on the importance of low vision services. The
pilot was planned to demonstrate a multi-
stakeholder approach to the development
of low vision services across Rajasthan. The
following organisations participated in the pilot
project; the Government of Rajasthan through
SSA, the Department of Health, civil society
organisations, eye hospitals and Sightsavers,
as the technical support agency. In the first
phase, low vision assessment camps were
held in three districts; Barmer, Jasalmer,
and Bhilwarda. Barmer and Jasalmer were
selected because they are challenging desert
areas in which to work, but also areas in which
our partner, Society to Uplift Rural Economy
(SURE), has a strong field presence. Bhilwada
was selected because this was an area in
which Sightsavers had never worked before.
It was decided that Sightsavers would provide
financial support in all three districts, but would
only provide low vision devices in Barmer
and Jaisalmer districts, where Sightsavers
already has education projects. For Bhilwada,
it was agreed that the Department of Health
would provide assistive devices by making
appropriate budgetary provisions through the
national programme for control of blindness,
funded by the Government of India. The
Department of Education agreed to cover
logistical expenses.
Two civil society partners, SURE for Barmer
and Jaisalmer districts, and Ramsnehi
Chikitsalaya for Bhilwada, were identified to
coordinate activities in the districts. Ramsnehi
Chikitsalaya has a well-developed eye hospital
with a low vision department and so also
provided technical support to the project in
Bhilwada. I-care Noida eye hospital played a
similar role as technical agency in Barmer and
Jaisalmer.
Process
A meeting of all stakeholders was called by
the commissioner of SSA, to discuss the
modus operandi and to clarify the individual

organisational roles. The Department of
Health was represented by the joint director
of eye health services who committed money
for the assistive devices and also pledged
to ensure that government health centres
were available for the low vision assessment
camps. The joint director also agreed to fast
track the clearance of invoices raised by the
implementing partners in order to ensure
a smooth flow of funds to the pilot project.
A detailed plan was mapped out which was
sensitive to local realities. A district level
committee under the chairmanship of the
district magistrate was also formed to ensure
the effective coordination and implementation
of the project.
Identification and assessment
of children
In Barmer and Jaisalmer, over 300 children
with severe visual impairments had already
been identified through surveys and regular
school screening activities carried out by
Sightsavers’ partner SURE. These pre-
identified children were invited to attend a
camp where experts from the I-Care eye
hospital provided full visual assessments.
Since Sightsavers had not worked in Bhilwada
before, an different strategy for identifying
children with visual impairment was adopted in
this district. Our technical partner, Ramsnehi
Chikitsalaya, with the support of SSA,
developed the capacities of school teachers
to screen children for eye problems. The
trained teachers then referred any identified
children to block level camps organised by
Ramsnehi Chikitsalaya. (In India, districts are
divided into blocks, with each block having a
population of approximately 200,000.) Children
screened through these camps were referred
to Ramsnehi Chikitsalaya’s base hospital for a
secondary level low vision assessment.
The project ensured that parents and
respective special educators were present
during the low vision assessments and during
training sessions on the use of assistive
devices, so that they would be able to help the
children later.
Outcomes
The pilot project has been successful in
terms of establishing the need for low vision
assessments, and the need for assistive
devices and appropriate educational materials
(e.g. large print books) to be available to
all children who require them. The state
government has since included low vision
assessment and sight restoring surgeries in
their annual plan, working in conjunction with
tertiary centres.
During the pilot, 229 children with low vision
were identified and supported with appropriate
learning devices or materials. An additional
93 children were referred for sight restoring
surgery, in most cases for bilateral cataract.
25,615 children with eye problems were
referred in the three districts and 1,018 children
©LauraCrow/Sightsavers
Using a magnifying dome to read

received spectacles for uncorrected refractive
error. At the camps, disability certificates were
provided for children who needed them.
For the first time in Rajasthan, various
departments and civil society organisations
worked together to provide low vision services.
The formation of an empowered district-level
committee helped to transfer ownership from
state to district level. The project has also
enhanced the capacity of the district teams of
the Government of Rajasthan to organise low
vision assessment camps.
Challenges
However, challenges were also encountered.
We initially found it difficult to bring all the key
stakeholders together on one single platform.
However, the SSA took the lead in inviting all
departments and eye hospitals for a meeting
to make them aware of the need for low vision
services and the roles that each of them could
play in this project. Receiving this invitation
from the Government appealed to the
stakeholders and encouraged them to attend
the meeting.
There were difficulties in mobilising school
teachers for the pilot project as many were not
interested in receiving training on low vision
issues. To address this, the SSA issued specific
orders to target physical training instructors
(PTIs), as it is their responsibility to ensure
good health among school children.
We also found it difficult to reach many low
vision children who were not attending school,
particularly in Bhilwada district. To combat
this problem, local civil society organisations
were encouraged to reach out to communities,
spreading the message and encouraging
parents to take their children to the nearest
block level camp to have their eyes examined.
Procuring assistive devices within the
government system was an entirely new
experience. It proved a tedious and time-
consuming process and, as a result, children
had to wait a long time before receiving the
necessary devices to support their education.
The SSA has learnt from this pilot project and
decided that devices will be procured by partner
eye hospitals, with costs being reimbursed
by the Government. It was also found that
there were no funds available within SSA and
that the eye health department allocation
for child surgeries was inadequate (only £10
per surgery). Hence partner hospitals had to
mobilise local resource to undertake surgeries.
Furthermore, technical agency staff found
it difficult to communicate with parents
and children due to dialect differences,
and so the assessment took longer than
expected. In general, parents were often
reluctant to cooperate with the project due
to their previous negative experiences with
eye hospitals. The special educators and
Sightsavers’ partners worked as a bridge
between technical staff, parents and children
to provide translation and ensure that the key
messages were delivered and understood.
Learning and way forward
Venturing into a formal partnership with
various stakeholders was a major step in
ensuring the availability of low vision services
in Rajasthan. This is the first partnership of
its kind in the state and it demonstrates that
creating links between the eye health and
education sectors is a key factor in ensuring
good quality education for all. The pilot has
also been successful in demonstrating how the
voluntary sector can complement the efforts of
governments to provide specific needs-based
support to children.
As part of this project, the eye health
department in Rajasthan has, for the first
time, provided support for low vision services.
However, to ensure continuity of services,
various issues need to be addressed. It was
noted during the project that there is a lack of
technical agencies available to undertake low
vision assessments and we therefore believe
it is important that local hospitals should
be persuaded to provide these services in
the future. It was also noted that low vision
assessments could be integrated with existing
routine assessment camps, such as those for
hearing and orthopaedics.
Though this pilot project has achieved
scale in terms of policy influence, the next
challenge will be the effective implementation
of the approach in all 33 districts in Rajasthan.
The Government of Rajhasthan has allocated
INR5,250,000 (£72,500) towards this activity
for the first year, but, given the limited
availability of technical agencies to carry out
low vision assessments, it has set an initial
target of reaching 5000 low vision children.
They are, however, committed to allocating
additional funding if ways are found to reach
more children.

Supporting Integrated Education in
Sierra Leone
Tiangay Gondoe, Project Officer, Sierra Leone
©AndyWeekes/Sightsavers
Milton Margai students
Introduction
Sierra Leone is a country located on the
western coast of West Africa, with a total
landmass of 71,740 square kilometres and a
climate that is predominantly tropical. It has
a population of 5.3 million1
with an annual
growth rate of 2.1 percent.
The country is divided into four regions;
Western Area, Southern, Eastern and Northern
Province, with Freetown, the national capital,
being located in the Western Area. Sierra
Leone is one of the world’s poorest countries,
ranking 180 out of 187 on the Human
Development Index.2
Efforts to provide special education services
for blind and visually impaired children date
back to the 1950s, when the Sierra Leone
Blind Welfare Society was set up by nationals
and expatriates. More recently, Sightsavers
has promoted integrated education through its
support for Milton Margai School for the Blind
in Freetown.
Approach
Milton Margai School is a special school for
primary aged children with visual impairment.
These students are not only taught at the
school, but stay in the school hostel during
school term and return to their homes during
the school holidays. With financial and
1
UNDP Human Development Report 2011
2
Ibid.

material assistance from Sightsavers, Milton
Margai School now also supports integrated
education for secondary aged children
with visual impairment. These students are
enrolled in mainstream schools in Freetown,
but also stay in the hostel at Milton Margai
School during school term. The programme is
monitored by the Special Needs Desk of the
Ministry of Education, Science and Technology
(MoEST) and by Sightsavers.
The programme provides students with the
necessary learning materials to ensure that,
as much as possible, they have the same
learning as their sighted peers. Mainstream
teachers also receive training in the education
of children with visual impairment. Before the
reopening of schools for the new school year,
the integration teacher, Mr Bernard Kaikai,
who is based in Freetown, visits all mainstream
schools participating in the programme
in order to sensitise staff on teaching and
learning for students with visual impairment. In
addition to this, as the school term progresses,
he carries out regular monitoring in the various
mainstream schools to find out about students’
progress and discuss any constraints.
At present, 27 boys and 14 girls are enrolled
in the primary section of Milton Margai School
for the Blind, while 15 boys and nine girls are
supported in eight mainstream secondary
schools in Freetown. The latter students have
been provided with Braille text books and
various types of equipment, such as tape
recorders, typewriters, Braille papers and a
stylus and writing frame.
Key successes
In the midst of the challenges of having visually
impaired students in mainstream secondary
schools, there are some successes that need
to be shared:
v
All pupils in the integrated education
programme have complete sets of learning
materials which include typewriters, tape
recorders, cassettes, and Braille papers.
Most prescribed text books have been
transcribed into Braille and are available in
the library of Milton Margai School.
v
The progress of the pupils has continually
improved throughout the programme and
all pupils in mainstream schools were
promoted to the next class during the last
academic year.
v
A Community Teachers Association (CTA)
has recently been formed by teachers of
Milton Margai School and parents of visually
impaired pupils at primary and secondary
level. Meetings are held twice a term to
discuss the pupils’ progress in school
and their well-being. Any constraints or
challenges are discussed and decisions
made on how they can be overcome.
v
Milton Margai School conducts outreach
programmes, visiting local communities and
raising their awareness that visually impaired
children can play a full role in society if they
are given the chance to enroll in school.
For example, community members are told
that the former principals of Fourah Bay
College and Milton Margai School were both
blind. This has further increased enrollment
as perceptions of children with visual
impairment continue to change.
Challenges
The past five years has been very challenging
for the Integrated Education Programme.
Some of these challenges are highlighted
below:
v
Resources planned for the programme
were drastically reduced due to the global
economic downturn and a reduced funding
allocation for the programme.
v
Late payment or non-payment of
government grants continues to affect the
smooth running of Milton Margai school,
leading (for instance) to the late opening of
the school.
©Sightsavers
Students at Milton Margai School for the Blind,
Freetown

v
Though the Ministry of Education, Science
and Technology has a Special Needs Desk,
it is under resourced and under staffed. It
has not developed any clear policy as to how
children with disabilities should be integrated
in mainstream secondary schools.
v
Teachers in mainstream secondary
schools do not yet have the capacities and
resources to provide high quality support
for students with special educational
needs. However, this is being addressed
via support visits from Milton Margai’s
integration teacher, and plans to hold a
series of training workshops for mainstream
secondary teachers during the 2012/2013
academic year. Sightsavers is also
advocating for teacher training colleges
to include special needs training in their
curriculum.
Learning
There has been a lot of learning during the
implementation of the Integrated Education
Programme. This will be used to reshape the
programme further.
It is evident from a recent external evaluation
that the development of effective reading
and writing skills through Braille is a critical
requirement for effective educational
inclusion. This is a key factor for the success
of blind pupils in mainstream schools
and is demonstrated by the Milton Margai
programme.3
Lessons learnt from the evaluation also show
that the programme has directly and indirectly
contributed to the building of human and
organisational capital within mainstream
schools, and to the promotion of positive
Case Study
Memunatu Turay
Memunata Turay, or Memuna as she is fondly
known, is a 17 year old student. She was born
in a village within Moyamba District, in the
south of Sierra Leone, and became blind due
to measles when she was four years old. Her
family believed that she had been bewitched
and did not think that she could participate
in the community. Memuna was therefore left
at home when her peers started school. An
education was totally ruled out for her.
However, things changed when Memuna’s
aunt, who had been a teacher in Freetown,
visited the village. She convinced Memuna’s
parents that she should be allowed to
attend Milton Margai School for the Blind in
Freetown and Memuna started at the school
in 2001, when she was six years old.
Since then, Memuna has worked very
hard to complete her primary education.
She sat the Basic School Certificate Exam
last school year (2010-2011) and is now in
Senior Secondary School One (SS1) at the
Methodist Girls High School in Freetown.
As a blind girl in a mainstream secondary
school, she had faced many challenges
during her first year in school, including the
unfamiliar environment and discrimination
among friends. However, she told Sightsavers
that this is now a thing of the past; her friends
are now aware that a disabled person is just
like any of them. Her friends have also helped
her to understand her new environment and
Memuna now runs around like everyone
else. When asked if she has challenges with
learning in class, she replied that sometimes
the teachers forget that there is a blind girl
among the sighted students; her friends help
her by dictating notes.
Memuna is very grateful to Sightsavers for
supporting her and the other students in
mainstream secondary schools with learning
materials, which include tape recorders,
typewriters, Braille papers, and writing frames.
Memuna wants to read law at University and
is very interested in the rights of disabled
people.
Memunata in her school uniform
©Sightsavers

attitudes towards children with disabilities
among head teachers, class teachers and
pupils.4
The Community Teachers Association, which
includes parents of visually impaired pupils,
has contributed to raising positive awareness
about visually impaired children within their
communities. Involving parents in meetings
to discuss their children’s progress and well-
being with the head teacher and teachers of
the Milton Margai School has given them more
confidence in their children’s abilities.
Milton Margai School, having promoted
integrated education for secondary-aged
children with visual impairment, is now
potentially capable of promoting integrated
education for primary-aged students.
Conclusion
The Integrated Education Programme has
completed its five year project cycle and has
recently been evaluated. The evaluation raised
certain concerns about the programme; for
instance, it was found that students were
denied the chance to study certain subjects
such as mathematics and science due to the
diagrams and visual methods used in these
subjects. Visually impaired students were
therefore restricted in their choice of subjects
and future career paths. Concern was also
expressed about the number of students
leaving the programme early. However, the
evaluation also found the majority of students
believed they had benefited significantly from
their participation in the programme, and that
this was reflected in their performance in
school.
Case Study
Foday Bangura
Foday Bangura is 16 years old and has been
attending Milton Margai School for the Blind
since he was eight.
At a very early stage, it was observed by
school staff that Foday was a promising
young boy and, if given the opportunity, would
do well in school. He passed an initial test
with very good grades and, instead of joining
the majority of his age group peers in class
three, was immediately promoted to class
four. He excelled in this class and quickly
finished his primary education. He was
enrolled at the Murray Town Municipal Junior
Secondary school, where he also excelled
and always topped the class.
Because of his outstanding performance,
Milton Margai staff decided to send him to
a private secondary school; The Modern
High School. The school has now secured
a scholarship for Foday, as he continues to
show exemplary competence among his
peers. The provision of learning materials
supplied to Foday by the Integrated
Education Project (IEP) has contributed to his
steady progress.
Foday continues to receive support from
the IEP, but is one of the few students now
residing with his parents. When asked how
it feels to live with his parents again after
spending eight years at the Milton Margai
School for the Blind, he said that he feels
much happier. He added that, while he was
also happy staying at the Milton Margai
hostel, the parental bond was missing. He
misses his friends at the hostel, as they were
all very much like a family to him, but says
that it is always best to live with your true
family if they accept you as a disabled child.
Foday reading Braille
©Sightsavers
3
IEP Evaluation Draft Report 2012
4
Ibid.

Child Friendly Inclusive Education in
Pakistan
Itfaq Khaliq Khan, Programme Officer, Pakistan
Leena Ahmed, Programme Officer, Pakistan
Ahmed Ghaznavi, Project Officer, Pakistan
©Sightsavers
A low vision child in the Federal Government School of Islamabad
Introduction
Inclusion is a term which expresses the
commitment to provide a quality education
in mainstream schools for every child, to
the maximum extent possible. It involves
bringing support services to the child, rather
than moving the child to the services, and
means that the child will benefit from being in
class. Full inclusion means that all students,
regardless of any distinguishing characteristic,
will be in a regular classroom/ programme
full time. All services must be provided for the
child in that setting.
Studies1 2
reveal that more than 90 percent
of children with disabilities in developing
countries do not attend school, and that
30 percent are deprived or living on the
streets. Furthermore, only three percent of
adults with disabilities are literate, and in
some countries only one percent of disabled
girls attend school. In Pakistan, inclusive
education has gained importance in last few
years. One of the greatest milestones is the
Government’s recent commitment reflected
in the National Education Policy, which has
endorsed Child Friendly Inclusive Education.
This new policy reflects the impact of advocacy
carried out by Sightsavers and other like-
minded organisations. The action plan for
the new education policy identifies the need
to provide training in inclusive strategies for
1
Tahir, R., and Khan, N. (2010). Analytical Study of School and Teacher Education Curricula for Students with Special
Educational Needs (SWSEN) in Pakistan: analysis and research annual, pp. 88.
2
Sightsavers (2003). Current status of the aetiology, prevalence and distribution of childhood blindness in Pakistan:
a report.

pre-service and in-service teachers. This is
because inclusive education cannot become a
reality unless teachers are equipped with the
necessary skills and knowledge.
Approach
Sightsavers believes in working systematically
with other stakeholders to pool efforts and
resources to promote the enrolment and
retention of all children who are currently out
of school, especially children with disabilities.
Sightsavers Pakistan has supported the
development of operational mechanisms and
procedures that facilitate inclusive strategies
within the wider education system, and will
work in close collaboration with the Ministry
of Education and other stakeholders focusing
on various aspects of Child Friendly Inclusive
Education.
Sightsavers supported a national blind school
survey in Pakistan in 2002, revealing that a
substantial number of students could be
enrolled in mainstream schools with some
support and guidance. The Government of
Pakistan’s National Policy for Persons with
Disabilities 20023
emphasised the inclusion of
children with disabilities in mainstream schools
by facilitating accessibility and opportunities for
learning in an inclusive environment. To endorse
this policy commitment, Sightsavers signed
a tripartite agreement with the Directorate
General of Special Education (DGSE) and the
Federal Directorate of Education (FDE) in 2003.
This agreement resulted in a project to pilot
inclusive education in Islamabad, in partnership
with DGSE and FDE.
The project facilitated the implementation of
inclusive education, initially in two schools, with
a special school selected as a midway centre
to prepare children with visual impairment to
move over to mainstream schools. With the
help of this initiative, Sightsavers has played a
key role in supporting FDE’s objectives to pilot
inclusion in mainstream schools.
Sightsavers believes that the onus of
implementing inclusive education rests
with the Ministry of Education (MoE), but
that this requires assistance from special
needs experts to build capacity to absorb
children with various disabilities into regular
schools. Sightsavers has demonstrated that
the inclusion of a significant proportion of
children with disabilities in regular schools is
possible. This project was evaluated in 2006
and, following recommendations to expand
the scope of inclusive education, six more
schools were added to this initiative in 2007.
International Development Partners, Norway
also encouraged and supported inclusive
education in eight schools. The pilot project
is now embedded firmly with the Federal
Directorate of Education.
As part of this pilot to promote Child Friendly
Inclusive Education in Pakistan, Sightsavers
used the following approaches:
v
Increased inter-organisational links between
the Ministry of Education and the Ministry
of Social Welfare and Special Education
(MoSW&SE) to make them realise that the
education of children with disabilities is a
joint responsibility of both ministries.
v
Networking with other like-minded
organisations working on education, which
has resulted in the formation of a National
Inclusive Education Core Group under the
leadership of the MoE.
v
Building capacities of teachers and other
relevant staff of the MoE, FDE and DGSE
in inclusive education strategies to support
students with special educational needs.
v
Ensuring accessibility in terms of school
infrastructure and educational materials.
v
Involving communities and Parent Teacher
Associations and raising their awareness of
their role in education.
v
Working with key stakeholders to advocate
to the Government and policy makers, with
the aim of ensuring endorsement of Child
Friendly Inclusive Education within the
National Education Policy.
Successes and challenges
Sightsavers has played a key role in supporting
the objective to pilot inclusion through the
child friendly schools concept. This role has
been recognised by all stakeholders at national
level and has raised our profile in the field of
inclusive education.
Sightsavers, along with UN agencies, has been
instrumental in establishing a National Core
Group for Child Friendly Inclusive Education
in the Ministry of Education. The core group
consists of key organisations seeking inclusive
3
Government of Pakistan Ministry of Women Development Social Welfare and Special Education (2002), National
Policy for Persons With Disabilities.

strategies in the education sector. The
founding members of the group were UNICEF,
UNESCO, Save the Children Sweden, Children
Global Network Pakistan, Federal Directorate
of Education, Allama Iqbal Open University
and Sightsavers. After a series of meetings,
the terms of reference for the group were
finalised and the group provided feedback to
the Government of Pakistan on issues such
as national education standards and teachers’
curriculum. With funding from UNICEF, the
group also commissioned a study to review the
status of child friendly education in Pakistan.
However, we have also faced various
challenges, particularly around sensitising
parents, teachers, school management, parent
teacher associations and local communities
towards the enrollment of children with
disabilities in mainstream schools. The
competing priorities of the MoE and
MoSW&SE, and their different departments,
also proved challenging and, now that the
MoE and MoSW&SE have been devolved,
Sightsavers is undertaking rigorous advocacy
with the provincial departments to ensure
an increased allocation of resources for the
education of children with disabilities.
Learning
Inclusive education means the inclusion of
all vulnerable children in schools, including
children with disabilities, children who are
out of school, children living on the street
and minority groups. Real inclusion involves
a gradual realignment of a school’s entire
programme. It is the joint responsibility of
both the MoE and MoSW&SE to cater for the
educational needs of children with disabilities,
along with other vulnerable groups.
It takes time to institutionalise changes through
gradual capacity building, demonstration
of pilot initiatives, building Public Private
Partnerships, and through joined up advocacy.
It is also vital to form partnerships and
alliances with relevant, influential stakeholders
to demonstrate pilot initiatives and to influence
the policy development and planning process.
Way forward
Our experience of working with teachers
has identified a dire need to train teachers
in inclusive strategies and health screening.
Sightsavers, with the support of other
stakeholders, will develop partnerships with
in-service and pre-service teacher training
centres to support this capacity development
process at provincial level. The establishment
of inclusive education resource centres
within pre-service teacher training centres
will be emphasised, so that the teachers can
acquire an awareness of the essential needs
of disabled children in schools, with the aim
of improving quality and retention. Sightsavers
will work with other stakeholders to integrate
inclusive education into both the pre- and
in-service teacher training curriculum across
Pakistan, undertaking advocacy with teacher
training institutes to achieve this goal.
Conclusion
To make ordinary classrooms truly inclusive,
we need a holistic approach to inclusive
education. This approach should focus on
developing inclusive education infrastructure,
providing accessible teaching and learning
resources, and building the capacity of
educators in inclusive education. It should also
focus on changing systems and structures
at school level, changing the curriculum to
be inclusive for all, and mobilising parents to
enroll their disabled children in mainstream
schools.
Providing quality education in an inclusive
setting is a challenging job, but it can be
achieved by developing strategic alliances
and networks with likeminded organisations,
building public private partnerships, and
undertaking joined up advocacy to raise the
awareness of those responsible for service
delivery. Committed and trained human
resources, physical accessibility, classrooms
and resource centres equipped with assistive
devices, and the involvement of Parent Teacher
Associations (PTAs) and the local community
can also pave the way for turning the dream of
inclusive education into a reality.
Two visually impaired students at school
©Sightsavers

The Right to Information:
Addressing the reproductive
health needs of visually impaired
adolescent girls
Jayashree Kumar, Programme Manager, North India
Monu Ravindran, Programme Officer, North India
©Sightsavers
Girls from the programme chat together
Introduction
India has one of the fastest growing youth
populations in the world, with an estimated
2431
million adolescents. According to the
United Nations, an adolescent is defined as
an individual between 10 and 19 years old.
However, the National Youth Policy 20032
recognises individuals from 13 to 19 years
old as a distinct age group, to be covered by
special programmes in all sectors, including
health. Adolescence is not only a period
of rapid change and maturation, but also
the time when a person grows emotionally
and cognitively; this age group represents a
resource for the future whose potential can
either be wasted or nurtured in a positive
manner. Sexual and reproductive ill health
is one of the major causes of morbidity
and mortality in young people3
, but in a
conservative society where reproductive and
sexual health issues are taboo for discussion,
1
UNICEF (2011). Adolescence: An Age of Opportunity, The State of the World’s Children Report 2011. New York:
UNICEF.
2
The National Youth Policy (2003) of India reiterates the commitment of the entire nation to the composite and all-
round development of the young persons of India.
3
World Health Organization (1998). The Second Decade: Improving Adolescent Health and Development. Geneva:
WHO.

young people are often hindered from actively
seeking counsel for their needs. Adolescents
are therefore identified as an underserved
group with particular health needs, and
for whom reproductive and sexual health
interventions need to be designed.
Girls up to the age of 19 years old comprise
about one quarter of India’s population and
the majority of them are out of school and
therefore do not receive services from school-
based health programmes. Access to, and
provision of, information is key to reducing
inequalities in health and social care for all
adolescents. However, within the family, girls
face a lot of discrimination and often receive
less health care, education and nutrition
than their male siblings. Many girls also have
limited opportunities for future education and
personal development, as they are caught
up in the cycle of early marriage, pregnancy
and childbearing. These young people are
therefore denied the rights guaranteed to them
by the UN Convention on the Rights of the
Child (1989) and the UN Convention on the
Rights of Persons with Disabilities (2006).
Young disabled people are among the most
marginalised and vulnerable of the world’s
young people. It has been estimated that
19 million children worldwide are visually
impaired. Of these, 1.4 million have irreversible
blindness.4
In India, an estimated 236,900
children up to the age of eighteen are visually
impaired, which is around 11 percent of the
total visually impaired population of India.
Of these children, around seven percent are
in the adolescent age group.5
It is widely
acknowledged that the greatest impediments
for young disabled people are prejudice,
social isolation and discrimination. While all
individuals with disability may be affected by
this lifelong cycle of stigma and prejudice,
visually impaired young people, especially girls,
are particularly at risk.
The Government of India has launched an
‘Adolescent Reproductive and Sexual Health
Programme’ under the National Rural Health
Mission6
, as part of the Reproductive and Child
Health Programme. However, the basic health
and reproductive health needs of disabled
young people have not been met effectively
through the programme. In the light of this,
Sightsavers decided to set up a pilot education
programme with a partner organisation
who was implementing a rehabilitation and
education programme. This initiative was later
replicated by five other Sightsavers partners.
The aim of the programme was to provide
adolescent girls with accurate, age appropriate
and culturally relevant information which would
enable them to respond to real life situations
in positive and responsible ways.
Approach
The pilot was initially started in Simga
Block, Raipur, in the state of Chhattisgarh.
Sightsavers’ partner, Grihini, a development
agency, had already identified a number of
visually impaired adolescent girls with health
problems living in the area. It was found that
their poor health was linked to poor nutrition
and a lack of awareness of their health needs
and rights.
Grihini organised meetings with the families of
the adolescents, during which the importance
of health education was emphasised. Initially,
the girls were reluctant to participate in the
programme, but they became more positive
when they recognised the programme’s
importance. Around 25 girls aged between
10 and 19 years of age were identified in the
project area and a programme on adolescent
health was organised for these girls in
consultation with them and their parents. The
programme included the following elements:
v
General health check-ups for participating
girls, combined with a haemoglobin check-
up and nutritional advice.
v
The provision of micro-nutrients, tonics, and
medicines for the girls when necessary.
v
Counselling sessions for the girls and their
mothers.
v
Information on gender discrimination and
physical and sexual abuse.
Various topics were discussed during the
programme, including the physical, mental,
and social changes which occur during
adolescence, the nature of the menstrual
cycle, the importance of good nutrition, health
problems due to unhygienic practices, and
4
http://www.who.int/mediacentre/factsheets/fs282/en/
5
http://mospi.nic.in/rept%20_%20pubn/485_final.pdf
6
Launched in 2005, NRHM seeks to provide universal access to equitable, affordable and quality healthcare to the
rural population throughout the country with special focus on 18 states with weak public health indicators.

issues related to physical and sexual abuse.
Staff from the partner organisation also
developed necklaces made of small and big
beads representing days of the month, to
explain the menstrual cycle. Each girl was given
a necklace to gain a better understanding of
the entire process by touching and feeling.
Female field workers from Grihini played key
roles during all stages of the programme and
a gynaecologist contributed to the counselling
sessions. All the girls received a health
examination, which included haemoglobin
levels, blood pressure, height and weight. For
most of the girls, their height and weight were
below average for their age, indicating the lack
of a nutritious diet.
The girls enjoyed participating in the
programme and said they had learned a
great deal. Their mothers were also positive
about the programme and said they would
now be able to provide better support for
their daughters. As a result of the success
of the programme, it was replicated with five
other partners; Raigarh Ambikapur Health
Association (RAHA) and Prerak in Chhattisgarh,
and Samaritans Social Service Society, Tarun
Sanskar and Dalit Sangh in Madhya Pradesh.
A different approach was applied here; with
pre- and post-programme tests being carried
out to assess understanding of the issues and
attitude change among the girls. It was found
that most of them lacked decision making and
communication skills prior to participating in
the programme. In total, 140 girls were covered
by the five partners.
Successes
The programme was successful in various
respects. It raised the self-confidence and
communication skills of the girls, encouraged
them to think more positively about puberty
and impending adulthood, and provided them
with a better understanding of health, hygiene
and rights issues. After the programme,
behavioural changes were observed among
the girls. For instance, they paid more attention
to personal hygiene during menstruation,
shared information with other girls from their
neighborhood and established friendship
groups with one another.
Positive changes were also observed
among the parents. For instance, one
mother observed: “I never thought that my
blind daughter also needed to know such
information. Whenever she has periods, she
would never go to school. Now I understood
that such changes are to be taken positively,
the bodily changes and mood swings etc. I am
very much concerned because of her disability,
how safe she is, and I feel this information on
reproductive health will surely bring changes
in the coming future. It was also good that we
became part of the programme and could
better understand the issues.”
Inclusive education and community-based
rehabilitation staff working for the partner
organisations also became more positive
and more aware of the issues facing visually
impaired adolescents.
Challenges
Although some of the partners were
experienced in implementing health
programmes, they still came across some
challenges.
Community and culture
The topics discussed in the programme were
very sensitive and still considered taboo in
rural India. Therefore, some family members
were initially reluctant to discuss them. To
overcome this, female field workers personally
met with the girls’ mothers and counselled
them on the importance of providing such
education and how it could help their
daughters to cope with challenging situations
in the future. Mothers were able to convince
other family members to allow their daughters
to participate in the programme.
The programme also worked to ensure that the
wider community understood the importance
of such education and services for visually
impaired girls. Community perceptions
were often not very positive and there was
a feeling that giving the girls access to this
information might encourage them to engage
in sexual activity. The programme worked to
combat this belief, and also to address other
misconceptions, such as strong, culturally-
embedded myths about menstrual hygiene.
Another challenge was that girls are often
not allowed to go to school, and are instead
expected to remain at home, looking after their
younger siblings and assisting their mothers.
Consequently, the girls themselves often had
a very limited understanding of the issues we
were attempting to address.

Expertise and teaching materials
All partner staff involved in counselling the girls
were experienced in adolescent health issues
and had sound counselling skills. However,
it was difficult to find experts who combined
these skills with an awareness of the particular
needs of adolescent visually impaired girls.
To overcome this problem, all staff involved in
the programme received awareness training
and were supported to develop teaching
and counseling methodologies that would
be suitable for use with visually impaired
adolescents.
Despite this training, partner staff were
hampered by the lack of Braille and tactile
education materials available on adolescent
health issues. During the programme, they
developed some materials themselves, such as
tactile bead necklaces to explain the different
stages of the menstrual cycle. However, going
forward, it will be necessary to address this
issue and develop materials for use in future
programmes.
Lastly, many of our project partners did not
have a sufficient number of female staff
members. Male staff found it challenging to
work with adolescent girls in a conservative
rural society, and it was therefore difficult for
these partners to provide the adolescent girls
with the one-to-one support they needed.
Learning
In order to improve the delivery of this
programme and others like it, Sightsavers North
India has noted some key learning points.
Overall this programme has shown that, if
adolescent visually impaired girls receive the
correct type of support, they can become
articulate, self-confident, and knowledgeable
young women. Good quality counselling
plays an important role in enhancing the self-
confidence and self-esteem of adolescent
girls. Partner organisations need to receive
thorough training and skills if they are to
provide this support.
Visually impaired girls need to be involved in
the planning of programmes such as this, to
ensure that the programme really meets their
needs. Once involved, they can also be trained
to play an important role as peer educators.
Visually impaired adolescents need to be
encouraged to access existing health services
provided by government hospitals and other
agencies. Appropriate health information and
education materials also need to be developed
for visually impaired adolescents.
Adolescent visually impaired girls are
vulnerable to sexual abuse and violence. They
therefore need to develop the capacity to
identify potentially threatening situations and to
seek the necessary support from appropriate
people and organisations. Good quality
programmes can help them to develop these
capacities. Communities as a whole, not just
individuals within those communities, need to
be sensitised on these issues. This will ensure
that the community works together to create
a safe and supportive environment for visually
impaired adolescent girls.
Way forward
The programme now intends to build on the
above successes and learning points. There
are plans to develop a training module for
project staff, to increase their knowledge of
adolescent health and hygiene issues for
visually impaired adolescent girls, and to
improve their capacity to address these issues.
Based on this identified need, an initial two
day training was conducted for the staff of two
partners in Madhya Pradesh. Together with
the help of external adolescent health experts,
the training covered issues such as health,
nutrition, gender and discrimination.
In addition to training project workers, the
programme also intends to develop and
disseminate Braille and tactile education
materials covering adolescent health and
social issues. These will be useful for project
staff and also for visually impaired adolescents
themselves.
Building on past success, the programme aims
to increase the number of participants and
also set up a specific initiative to target visually
impaired boys. Alongside this, to ensure
Having a health check up
©Sightsavers

sustainability of this initiative, the programme
aims to develop links with other development
agencies and with the Government, who
provides Adolescent Friendly Health Services
as a part of their health programme. The aim is
for existing health and education programmes
to address the needs of disabled adolescents,
thereby ensuring that appropriate services are
widely available and accessible, and that all
disabled adolescents are equipped with the
necessary life skills.
Conclusion
The Sightsavers-supported programme
in Madhya Pradesh and Chhattisgarh has
addressed the needs of a particularly
vulnerable target group. We now need to build
on the success of the programme to ensure
that as many disabled adolescents as possible
in India receive the various services they
require. Through these programmes, a large
group of adolescents will acquire the skills
to handle stressful situations and to protect
themselves from sexual abuse . We believe
this would be best achieved by ensuring
existing social, educational, and health
programmes address the needs of disabled
people, rather than through setting up special
programmes for disabled people. In the next
few years, Sightsavers India will therefore be
working closely with the government and non-
government agencies to achieve this ambition.
Case Study
Neeta
Neeta, a cheerful young woman aged 19, lives
in Thikri village, in the district of Hoshangabad
in Madhya Pradesh. She shares a house with
her mother, an agricultural labourer, and a
younger brother and sister. Neeta lost her
sight when she was four months old, when
she was travelling on a tractor trolley and
some sacks of grain fell on top of her. A real
example of women’s empowerment, Neeta’s
skills and confidence have developed with
the support of Dalit Sangh, Sightsavers’ local
partner. The team has supported Neeta with
her education and social rehabilitation for
the last four years. Being an energetic and
positive young woman, Neeta is now running
a successful grocery store and is due to
take her 12th grade senior secondary exams
through the National Open School . She is
actively working with local Disabled People’s
Organisations (DPOs) and dreams of taking
computer training and opening a computer
centre for village children.
Neeta was one of 25 girls who participated
in an adolescent education programme
organised by Dalit Sangh. Attending such
a programme for the first time was a huge
learning experience for Neeta. She expressed
her happiness, saying, “information regarding
the bodily changes, emotional changes,
health and hygiene was an eye opener for
me. At home, we cannot discuss our personal
problems, and our friends are the only people
with whom we can share our problems.
This type of knowledge helps to build up
our confidence and self-esteem. Now we
feel more comfortable with our bodily and
emotional changes and also ready to take on
life’s challenges.”
Her family says the most significant change
in Neeta is that, whereas before she was
disappointed with her life after losing her
sight, she now has the enthusiasm and
confidence to study further. She participates
in decision-making, not only within her family,
but in the local community as well. She is
studying and is very aware of her rights. As an
ambassador for the programme, Neeta has
shared all the information she received with
her friends.
Neeta in her shop
©Sightsavers

Braille champions in Narshingdi
district: the experience of
Sightsavers Bangladesh
Nusrat Zerin, Programme Officer, Bangladesh
©Sightsavers
Students learning computer skills in the ICT centre
Introduction
In Bangladesh, children with disabilities tend
to be either excluded from or marginalised
within the education system. This is especially
the case for children with visual impairment.
However, there is increasing awareness
in Bangladesh of how inclusive education
initiatives can improve the situation of disabled
children in mainstream schools and local
communities, particularly if communities and
school authorities are somehow engaged in
these initiatives. One way in which Sightsavers
Bangladesh has attempted to promote
inclusive education for children with visual
impairment is to support Braille champions
in Narshingdi district, whilst simultaneously
establishing a Braille and ICT learning centre.
Approach
Training Braille champions
Sightsavers and its non-government partner
organisation, Assistance for Blind Children
(ABC), decided to establish a pool of
community Braille champions in Narshingdi
district, to promote the teaching and learning
of Braille. In order to achieve this, visually
impaired community members, who had
previously had no experience of reading and
writing, were provided with training in Braille.
Similar assistance was provided for the parents
of visually impaired children, and other family
members who wanted to support the child to
complete his or her education. These trained
people then became Braille champions within
their communities.

The process of training the Braille champions
started with basic orientation on Braille,
provided by staff from Sightsavers and ABC.
First, the participants received training in pre-
Braille skills. They were asked to touch and
identify tactile objects, such as lentils, rice,
sticks and string, and also different types of
material, such as cotton, silk, wool and paper.
The participants were then asked to trace
strings and lines of materials with the pads
of their fingers. This helped them to practice
pre-Braille techniques and to gradually develop
their sense of touch. The participants were
then shown alphabet books, which contained
both the Bangla alphabet and the English
alphabet in Braille. Through touching the
Braille alphabets with their fingers, participants
started to learn the respective Braille codes.
At the same time, they learnt to solve simple
mathematical problems using Taylor frames
with dice. They also received training on how
to transfer their new knowledge to visually
impaired learners at the community level.
As a result of this training, parents, family
members and visually impaired community
members are now assisting local visually
impaired children to read and write Braille.
The children have welcomed this support and
are becoming more confident Braillists. In
addition, the family and community members
have become more aware of the educational
needs and potential of children with visual
impairment.
Setting up an ICT and Braille learning
centre
To make the inclusive education initiative more
effective, Sightsavers Bangladesh and ABC has
also established an ICT and Braille learning
centre within a primary school in Narshingdi
district. The centre is well equipped with
educational materials appropriate for both
blind students and students with low vision; for
instance, Braille writing frames with styluses,
optical and non-optical low vision devices, tape
recorders and Braille and large print books.
The resource centre also contains computers
with talking software and magnification
software, as well as some musical instruments.
The aim of the centre is to promote visual
Case Study
Rabeya Akhter
Rabeya Akhter is a successful Braille
champion within her community, providing
Braille support to visually impaired children in
her village. She is 28 years old and lives with
her parents in Baroigram village, which falls
under Narshingdi district in Bangladesh. She
is the eldest of five children.
When Rabeya was two months old she
developed a severe fever. Her parents took
her to a local traditional healer, who gave
her some herbal medicine. Following this,
Rabeya’s parents then noticed that she had
some problems with her vision and could
not identify toys or see properly. They visited
Dhaka Progressive Lions eye hospital in
Narshingdi, where doctors assessed Rabeya
and found that she had lost her vision and that
it was too late for any treatment.
Rabeya faced many problems with household
tasks and independent living; she depended
on family members for help, and local children
and other people from her community used
to tease her. Her parents had no information
about education for visually impaired children
and so Rabeya remained at home. She did not
have access to any recreational activities, was
not included in visits to relatives’ houses and
became very frustrated.
In 2003, a Community-Based Rehabilitation
(CBR) worker from Assistance for Blind
Braille champion Rabeya teaches Borsha
©Sightsavers

impairment friendly ICT at school level for
visually impaired children, and to involve
mainstream schools and the wider community
in inclusive education programme activities.
The centre allows visually impaired children to
access computers with appropriate software
and to develop their ICT skills. In Bangladesh,
ICT is compulsory in the school syllabus, but
schools only provide training to non-disabled
children, as they do not have the necessary
knowledge, skills and equipment to support
visually impaired learners. Through this
initiative, Sightsavers is demonstrating that
visually impaired children can develop valuable
ICT skills, and that school authorities and
relevant curriculum and policy makers should
ensure that visually impaired children are
included in the general ICT training provision
within schools.
Visually impaired students access the centre
on a daily basis and receive training in screen
reading software such as SuperNova and
JAWS. There is a plan to provide ICT training
to local visually impaired adults too, such
as the self-help group members who are
currently receiving Braille training and working
to support local visually impaired children with
their education. The centre is also benefiting
the wider community, with Braille champions,
sighted students and teachers using the
facility. The resource centre has increased
awareness of the educational needs and
potential of students with visual impairment at
the village and sub-district level.
The school authority, school management
committee, and local education officials of
Children (ABC), a partner organisation of
Sightsavers Bangladesh, identified Rabeya as
a visual impaired person. With support from
the CBR worker, Rabeya gradually acquired
daily living skills such as moving around
without assistance and cooking by herself.
She became more independent and was able
to interact with other community members
and exchange her views and opinions with
them.
Rabeya then joined a self-help group, formed
by local people with disabilities and facilitated
by ABC. She regularly attends the monthly
meetings and contributes to group activities.
Through this group, Rabeya has received
training on the basic concepts of CBR, as
well as leadership and advocacy skills, and is
involved in income generating activities such
as making candles to sell in the local market.
In 2011, Rabeya received Braille training
through the project. She was taught pre-
Braille techniques and provided with Braille
alphabet books developed by Sightsavers
Bangladesh. Project staff regularly followed
up on her progress and Rabeya can now read
and write well in Braille. She is starting to
support visually impaired children in her own
community by acting as a Braille champion.
Rabeya regularly teaches a visually impaired
girl, named Borsha Akhter, who is a student
in a mainstream government primary school.
Rabeya also provides pre -Braille support
to Borsha’s younger sister, Sayma, who is
three years old. She helps Sayma in touching
different objects to improve her tactile skills.
After that, Rabeya will introduce Sayma to the
Braille alphabet book, to help her understand
the position of Braille dots for each letter of
the alphabet.
Rabeya wants Borsha and Sayma to complete
their education and is ready to support them
throughout the process. Having had no
opportunity for education during her early
years, she is committed to supporting local
visually impaired children with Braille and
learning. Rabeya is now respected within her
community and recognised as a valuable
resource for others. She is keen to work
throughout her life to establish the rights of
disabled people in society, working together
with others at community level.
Becoming familiar with technology
©Sightsavers

Narshingdi district were very interested in this
initiative and have assumed responsibility for
running the centre since 2011.
Successes, challenges and
learning
As described, the above initiatives have not
only increased educational opportunities for
children with visual impairments (both blind
children and children with low vision), but
have also played an important role in raising
the awareness of a wide range of community
members. Sightsavers Bangladesh is now
replicating these initiatives in other education
and social inclusion projects and achieving
similar results.
One noticeable result of the project is that
school authorities and the general public
are becoming more aware that, given access
to appropriate software, visually impaired
people can use ICT effectively and develop
sophisticated ICT skills. However, one
challenge that Sightsavers and ABC face is
that only visually impaired children living in the
vicinity of the resource centre can regularly
access the various facilities within the centre.
Electricity outages also limit access to ICT
equipment at certain times.
Conclusion
Many of our Braille champions were illiterate
before they participated in the project. Now
they are literate and aware that they have a
right to education. They are also respected by
other community members who witness them
supporting local visually impaired children
with their studies. After the project has been
phased out, the Braille champions will be able
to continue assisting students in their local
communities.
In Bangladesh, students must have basic
computer skills from secondary level
onwards. Teachers and education officials
often assume that visually impaired students
are unable to participate in secondary
education because they cannot acquire the
necessary ICT skills. However, the initiatives
of Sightsavers Bangladesh and ABC have
shown that visually impaired students can
indeed acquire these skills and, consequently,
the assumptions of teachers and bureaucrats
are being challenged. In order to widen the
pool of visually impaired people who are
familiar with computers, Sightsavers and ABC
plan to provide further training in the future,
particularly in talking software. This in turn will
increase awareness among the general public
about the educational potential of people with
visual impairments.
Self help group members learning Braille
©Sightsavers

What lessons can we learn from our
experiences?
Guy Le Fanu, Programme Development Advisor: Education
The articles in this edition of Insight Plus
discuss Sightsavers-supported education
projects in five countries (India, Pakistan,
Bangladesh, Sierra Leone, and Belize). What
lessons can we draw from them?
1. The importance of effective
partnerships
The articles make clear that Sightsavers-
supported education projects are only
successful when they are grounded in
strong partnerships with appropriate sets of
stakeholders. Wherever possible, we should
work closely with government agencies.
However, we also often need to work closely
with the non-government sector and civil
society organisations, particularly when
governments lack local presence. These
partnerships are often complex and evolving,
and therefore need to be skilfully managed.
2. The importance of flexibility
The articles describe how Sightsavers has
responded imaginatively to different kinds of
need. In Bangladesh, we supported Braille
champions because there was a need to
promote the reading and writing of Braille in
local communities (Zerin). In North India, we
facilitated support for a particularly vulnerable
target group – adolescent girls with visual
impairments (Kumar and Ravindran). And in
Sierra Leone we worked closely with a special
school because it had the capacity to promote
integrated education in secondary schools in
Freetown (Gondoe).
3. The value of multiple interventions
In the field of education, Sightsavers directly
supports service provision – for instance,
through providing equipment for schools and
funding teacher training. However, the articles
describe how we can combine this intervention
with other types of initiative. For instance, Itfaq
Khan, Leena Ahmed, and Ahmed Ghaznavi
describe how we have promoted inclusive
education in Pakistan through networking and
advocacy at national and provincial levels.
And Nitin Sharma describes how we have
strengthened education systems in Rajasthan
by (for instance) establishing links between
different government agencies.
4. ‘Education’ should not be narrowly
equated with ‘schooling’
The educational needs of disabled children
cannot be fully met in schools. We therefore
need to support other types of educational
initiatives. It is particularly important that we
support early childhood care and education as
this is vital for children’s future development.
The article by Joan Musa, Joan Samuels, and
Philip Hand describes how we have done this
in Belize. We can also support educational
initiatives for older children, adolescents, and
adults. For instance, Jayashree Kumar and
Monu Ravindran describe how we have helped
non-governmental organisations in India to
provide health advice and counselling for
teenage girls.
I have only had the opportunity to briefly
discuss some of the lessons that can be
drawn from this fascinating set of articles. I
therefore hope that all our staff will find the
time to read them carefully and draw their own
conclusions. I also believe that anyone involved
in international development will benefit from
reading and reflecting on them.
Guy Le Fanu
©Sightsavers

www.sightsavers.orgPage 32www.sightsavers.org Registered charity numbers 207544 & SC038110
Sightsavers
Grosvenor Hall
Bolnore Road
Haywards Heath
West Sussex
RH16 4BX
UK
Tel: +44 (0) 1444 446600
Fax: +44 (0) 1444 446688

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