Notes on disability in ethiopia january 2008


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Notes on disability in ethiopia january 2008

  1. 1. Notes on Disability in Ethiopia Notes on Disability in EthiopiaContents1 Introduction .............................................................................................................................2 1.1 Prevalence and Forms of Disability .................................................................................2 1.2 Situation of Persons with Disabilities ............................................................................. 32 Legal and Policy Framework .................................................................................................. 53 Stakeholders ........................................................................................................................... 6 3.1.1 State Actors .............................................................................................................. 6 3.1.2 Non-State Actors...................................................................................................... 7 3.1.3 PwD Organizations .................................................................................................. 9(January 2008)Ghetnet Metiku WoldegiorgisSocio-Legal ResearcherE-mail: Page 1
  2. 2. Notes on Disability in Ethiopia1 Introduction1.1 Prevalence and Forms of DisabilityThe 1994 Census in Ethiopia reported that there were nearly one million persons with disabilities inEthiopia constituting less than two percent of the total population. However, this report is far belowinternational estimates on the prevalence of disability in developing countries.1 According to the finalreport submitted by the Special Rapporteur on Human Rights and Disability (1991) at least 1 out of 10persons has a physical, mental or sensory impairment, and at least 25 percent of the total population areadversely impacted by the presence of disabilities.2 Similarly, WHO and World Bank estimates of overalldisability prevalence in developing countries is 10% of the entire population.Even subsequent official reports have criticized this report on grounds of narrow identification criteria,exclusion of less accessible social groups such as the homeless and substantial underreporting byreluctant families.3 Accordingly, the National Plan of Action for Children estimates the total number ofpersons with disabilities in Ethiopia at around 4.9 million or seven percent of the total population of 70million in 2003. Current estimates put the number of people with disabilities in Ethiopia around 4.5million, of whom 50,000 live in Addis Ababa.4 Distribution of Disabled Population by Region: - 1994 Census Region All Persons PWD’s Ratio1 Tigray 3, 134, 470 90,742 2.80%2 Amhara 13,828,909 281,291 2.03%3 Oromiya 18,465,449 333,653 1.80%4 South N. 10,368,449 174,941 1.69%5 Addis Ababa 2,100,031 45,936 2.18%6 Dire Dawa 248,549 4,226 1.70%7 Gambella 162,271 2,581 1.59%8 Benishangul Gumuz 460,325 7,341 1.59%9 Afar 1,097,067 14,140 1.29%10 Harari 130,691 2,909 2.23%11 Somali 3,382,702 34,156 1.00% Total 53,379,035 991,916 1.85%In terms of forms of disability, the Developmental Social Welfare Policy identifies sight, hearing andspeaking impairments; physical disability of the limbs; and, mental health problems as the moreprevalent forms of disabilities in Ethiopia. Similarly, the WHO reported that total or partial blindness(32%), leg or arm impairment (32%), and hearing/speech impairment (19%) are the most prevalent1 GFDRE & UNICEF, 2001; IER, 1995;2 UNICEF, (2002) Implementation Handbook for the Convention on the Rights of the Child, p.3253 Ethiopia’s National Plan of Action for Children , p. 244 Handicap International (available at: 2008)Ghetnet Metiku WoldegiorgisSocio-Legal ResearcherE-mail: Page 2
  3. 3. Notes on Disability in Ethiopiaforms of disability in Ethiopia while mental disability is also frequent.5 These forms of disability arelikewise prevalent among children with disability (CwDs), who constitute more than half of PwDs inEthiopia.6 Types of Disability in Ethiopia – 1994 Census Types of disability % of population Hearing & Speech defect 5.9 Intellectual 6.5 Hand/Arm problems 8.8 Total blindness 11.9 Hearing impairments 13.3 Partial blindness 20.4 Leg problems 23.3 Overlapping 3.2 Leprosy 3.5 Other 3.21.2 Situation of Persons with Disabilities In 2003, there were 26 orthopedic technicians and 80 physiotherapists in the country, which is considerably low considering the prevalence of impairment of the limbs among PwDs.7 Though the government is currently establishing facilities for the manufacture of assistive appliances in different parts of the country, there is an acute lack of early detection screening as well as rehabilitation facilities for PwDs. Due to physical and social barriers preventing their integration and effective participation in the community, PwDs have limited access to existing health services. Infanticide of children with disabilities by parents is practiced in parts of Ethiopia owing to fear of the difficulty of raising the child and discrimination.The total number of children with disabilities enrolled in schools is extremely low. Education SectorDevelopment Programme III estimates the total number of school age children with special needsbetween 1.7 million to 3.4 million.85 WHO, Disability in Ethiopia: The Scope of the Problem (available at: Ethiopia’s National Plan of Action for Children, 2004, p. 247 National Programme of Action for Persons with Disability8 Ministry of Education, Education Sector Development Programme III, p.26(January 2008)Ghetnet Metiku WoldegiorgisSocio-Legal ResearcherE-mail: Page 3
  4. 4. Notes on Disability in Ethiopia An estimated less than 1% of children and students with special needs get access to primary education9 and very few of them continue in vocational, secondary and higher education. The special schools for children with disabilities are overcrowded and suffer from lack of special instructional materials and facilities and shortage of staff specialized in special needs education. The few existing special schools, inclusive schools have also been faced with financial constraints.10 The delivery of early childhood development programs does not reach the majority of children with disabilities and appears to be left to NGOs many of which are inadequately resourced.11 The National Programme of Action for the Rehabilitation of Persons with Disabilities states that efforts by both governmental and non-governmental bodies to offer vocational training to persons with disabilities are inadequate compared to the number of persons in need.12 The training institutions established by non-governmental institutions are few in number and ridden with resource shortage. The vocational training institutions currently operational are not accessible to PwDs due problems of design and willingness to enroll PwDs. The majority of children with disabilities are hidden at their homes or begging on the streets and near churches and mosques.13 Persons with hearing impairment and other persons with disabilities do not have access to information on vital matters such as the HIV/AIDS epidemic and reproductive health.14 The exploitation of PwDs, especially children with disabilities, for begging by unscrupulous individuals is widespread. Handlers sometimes maimed or blinded children to raise their earnings from begging.15 CwDs, especially girls with limited mobility or visual impairment, are among the groups most exposed to sexual violence.169 MoE, Special Needs Education Strategy, 200610 Professor Tirussew Teferra, (2005), Disability in Ethiopia: Issues, Insights and Implications, p.8611 Ethiopia’s National Plan of Action for Children, p.2512 MoLSA, Plan of Action for the Rehabilitation of Persons with Disabilities, 199913 Ibid.14 Information obtained from Ethiopian National Association of the Deaf.15 US Department Report on Human Rights Practices in Ethiopia 2005.16 MoLSA, National Plan of Action on Sexual Abuse and Exploitation of Children, December 2005, p 7(January 2008)Ghetnet Metiku WoldegiorgisSocio-Legal ResearcherE-mail: Page 4
  5. 5. Notes on Disability in Ethiopia2 Legal and Policy FrameworkArticle 25 of the FDRE Constitution provides that all persons are equal before the law and entitledwithout discrimination to the equal protection of the law. Discrimination on the basis of disability is notexplicitly mentioned, though the phrase ‘other status’ includes disability. Article 41 of the Constitutionprovides that the State shall, within available means, allocate resources to provide rehabilitation andassistance to persons with physical and mental disabilities.Though there is no separate policy on PwDs, disability issues have been extensively covered under theDevelopmental Social Welfare Policy adopted in November 1996. The specific priority areas identified inthe Policy include the following: Ensuring conducive environment for the effective participation of persons with disabilities Provision of education, skill training and gainful employment opportunities to persons with disabilities Provision of medical/health services and supportive appliances The creation of mechanisms by which support services will be provided for persons with disabilities in the context of their family and community environment The establishment of special centers where persons with disabilities will be cared for Awareness raising to the public concerning the determinants and consequences of disability and combating discriminatory attitudes Designing and implementing strategies and programs to prevent the prevalence of disability and mitigate its effects Ensuring barrier-free physical access to persons with disabilities in residential areas, work, and other public places Provision of support and assistance to community action groups, non-governmental organizations as well as voluntary associations engaged in the provision of services to persons with disabilities.In 1999, the Ministry of Labour and Social Affairs designed a National Program of Action for theRehabilitation of Persons with Disabilities that aims to operationalize the UN Standards Rules onEqualization of Opportunities for Persons with Disabilities and the Developmental Social WelfarePolicy of Ethiopia. The major objectives of the Program are: Taking disability prevention measures by promoting community participation Enabling persons with disabilities to achieve a better standard of living by building their capacity(January 2008)Ghetnet Metiku WoldegiorgisSocio-Legal ResearcherE-mail: Page 5
  6. 6. Notes on Disability in Ethiopia Ensuring the equal rights of persons with disability and their full participation in societyThe areas of focus identified in the program are prevention of disability, medical rehabilitation,educational rehabilitation, vocational rehabilitation and employment services, accessibility, awareness-raising, strengthening and expanding organizations’ of persons with disabilities, religion, culture, sport,recreation and family life. However, the Program does not provide for a timetable for theimplementation of these activities making it difficult to monitor progress. Thus, the implementation ofthe Developmental Social Welfare Policy and the National Program of Action for the Rehabilitation ofPersons with Disabilities remains a challenge.The National Programme of Action for Children for the period 2003 – 2010 and beyond, which wasissued in June 2004, has also set up a national consultative mechanism involving sector ministries andthe Federation of Persons with Disabilities to coordinate and oversee the implementation of CommunityBased Rehabilitation (CBR) programs targeting CwDs. Moreover, due to their primary mandates inrelevant sectors, various ministries and their regional counterparts are among the key state actors inthe realization of PwD’s rights. These include the Ministry of Health, the Ministry of Education, theMinistry of Women’s Affairs, and the Ministry of Information.In December 2005, the Ministry of Labor and Social Affairs issued a National Plan of Action on SexualAbuse and Exploitation of Children (2006 - 2010) with the aim of improving the protection of childrenfrom sexual abuse and exploitation and access to legal, psychosocial and medical information andservices. At the outset, the Plan of Action has identified CwDs among the groups most vulnerable toviolence, including sexual violence. To this end, the document has identified four areas ofintervention: prevention, protection, rehabilitation and reintegration, and coordination andmonitoring.3 Stakeholders3.1.1 State ActorsThe Department for Rehabilitation Affairs within the Ministry of Labour and Social Affairs is the bodyresponsible for coordination of disability issues at the federal level. The Department is charged with theduty to “Study and in cooperation with other organs, ensure the implementation of ways and means of providing assistance to the aged and persons with disabilities as well as the rehabilitation of persons with disabilities”.17This mandate extends to: designing policy, strategies to deal with the PwD’s issues at a national level;and implementing specific programs such as capacity building training, establishment of institutions forproduction of prosthetic devices, dissemination of information, and strengthening DPOs and otherorganizations working on disability issues at the federal level.17 Proclamation to define the Powers and Duties of the Executive Branches of the FDRE (Proclamation 4/1995), Article 20 (10)(January 2008)Ghetnet Metiku WoldegiorgisSocio-Legal ResearcherE-mail: Page 6
  7. 7. Notes on Disability in EthiopiaAt regional level, Bureaus of Labor and Social Affairs are responsible for implementation of the policyand national programme of action. The Bureaus also coordinate interventions by both state and non-state actors to address disability issues and realize the rights of PwDs. In Addis Ababa, the task isundertaken by the Social and Civil Affairs Bureau.In 2002, a national forum of organizations working in the field of disability was formed as a MoLSAinitiative to create space for non-state actors, coordinate disability related interventions and shareexperiences. Though not directly focused on disability, the multi-sectoral Networking of OrganisationsWorking in Support of Orphans and Vulnerable Children (OVC Network) are also important in thecoordination of interventions on disability issues. Moreover, there are a number of other institutionalframeworks established to coordinate initiatives directly related to violence against PwDs, especiallywomen and children, in Ethiopia. These include the CRC implementation structure (child rightsadministration), high level taskforces on child labor, orphans and vulnerable children and trafficking inpersons, the National Steering Committee on Sexual Abuse and Exploitation of Children, and theNational Steering Committee on Justice Reform.In 2006, the Ministry of Justice has established a Center specializing in Prevention, Prosecution andLegal Support in cases of violence against women and children in Addis Ababa in collaboration withUNICEF.18 The Center undertakes prevention, counseling,19 investigation and prosecution of VAWCthrough coordination among Courts, police and prosecution towards a more speedy investigation andprosecution as well as increases in conviction rates. The success of the VAWC Center in Addis Ababa hasprompted similar initiatives at the regional level. A case in point is the establishment of a specializedprosecution office for crimes against women and children in the Amhara Region. Moreover, with a viewto addressing the significant gap in legal aid service provision, law faculties of government universitieshave established legal clinics using academic staff and students to provide free legal services as part ofthe education process. Currently, at least three government universities at Mekelle, Bahir Dar andAwassa have established legal aid centers.3.1.2 Non-State ActorsA large number of non-state actors representing a broad profile of organizations are working toimprove the situation of the rights of PwDs in Ethiopia at various levels in collaboration with thegovernment and government agencies. These include UN agencies, Inter-Governmental Organizations,international NGOs, indigenous NGOs, community-based organizations (CBOs), faith-basedorganizations (FBOs) women’s associations, childrens organizations and youth associations. While themandates of most of these institutional actors may be defined in terms of sectors or vulnerable groupsthey focus on, many address the problems, issues and rights of PwDs.These organizations use different approaches including awareness raising, conducting researches andsurveys, advocacy and lobbying, and community based development initiatives. Important areas ofengagement for non-state actors are:18 The Centre has been established in the Lideta branch of the FFIC. The Ministry of Justice is also in the process of establishing a similar office in Dire Dawa.19 The VAWC Prevention, Prosecution and Legal Support Center has not yet comprehensively included the provision of psychosocial and medical services as well as rehabilitation and reintegration of victims.(January 2008)Ghetnet Metiku WoldegiorgisSocio-Legal ResearcherE-mail: Page 7
  8. 8. Notes on Disability in Ethiopia awareness raising and advocacy initiatives that aim at change of laws and practices at the formal and non-formal level; capacity building support to judicial, law enforcement and other structures involved in prevention and protection; and providing support to vulnerable groups as well as victims of violence.A number of national NGOs operate shelters for vulnerable groups and victims of violence. Theseinclude: The FSCE drop-in center that provides counseling and rehabilitation services to children who are victims of prostitution in Addis Ababa; The African Network on Prevention and Protection of Child Abuse and Neglect (ANPPCAN) supports community-based Child Abuse Reporting Centre in Woldia (North Shewa Zone, Amhara). Integrated Family Support Organization (IFSO) provides counseling for victims of rape, while the Tsotawi Ttekat Tekelakay Mahiber (TTTM) provides shelter and accommodations in Addis Ababa, and The Organization for the Prevention, Rehabilitation and Integration of Female Street Children (OPRIFS) provides safe home for girls in Addis Ababa.Legal aid services are also provided by NGOs. These include: Legal advice, counseling and representation provided by the Ethiopian Women Lawyers Association (EWLA) to victims of GBV/VAWC in criminal and civil cases in Addis Ababa, Nazareth, Dire Dawa, Awassa, Gambella, Assosa, and Bahir Dar. Legal services provided by the Action of Professionals Association for the People through ten legal and human rights resource centers, three joint projects with regional legal professionals’ associations and two legal aid centers in Addis Ababa, Bahir Dar, Awassa, Dire Dawa, Jimma, Harar, Adama, Assela, and Debre Berhan. Free (pro bono) legal services provided by the Ethiopian Bar Association in the premises of the Federal High Court in Addis Ababa.ANPPCAN – Ethiopia has established a helpline for children called Reporting Center for Child Abuse inAddis Abada. The Child Helpline operates 10 hours a day and provides medical, counseling, legal andfamily reunification services for victims of child abuse. EWLA has completed preparations tocommence an additional hotline service for victims of gender based violence in 2008.(January 2008)Ghetnet Metiku WoldegiorgisSocio-Legal ResearcherE-mail: Page 8
  9. 9. Notes on Disability in Ethiopia3.1.3 PwD OrganizationsA category of CSOs/NGOs that may be considered separately are associations established by PwDs andorganizations directly working on disability issues (DPOs). Most of the DPOs are members of theEthiopian Federation of Persons with Disabilities. The Federation is an umbrella organization of fivesingle disability focused national associations. These are: The Ethiopian National Association of the Blind, The Ethiopian National Association of the Deaf, The Ethiopian National Association of Ex-Leprosy Patients, The Ethiopian National Association of Mentally, Retarded Children and Youth.The Federation and member associations are engaged in advocating for cessation of socialdiscrimination and promoting the rights of PwDs. Their activities include advocacy and awarenessraising, initiating research and information gathering activities, offering capacity building as well aseconomic empowerment and integration of persons with disabilities.Other organizations focusing directly on disability issues include the Ethiopian National Association ofthe Physically Handicapped (ENAPH), Handicap International, Rehabilitation and Preventive InitiativeAgainst Disability (RAPID), SALU Self-Help Blind and Handicap Association, Addis Ababa SportFederation of the Disabled and Cheshire Services Ethiopia. These organizations are among those activelyengaged in the implementation of comprehensive community based rehabilitation (CBR) activities.Handicap National has been engaged in the implementation of comprehensive community basedrehabilitation (CCBR) activities since its establishment in 1998. One of the components of theComprehensive Community Based Rehabilitation as implemented by Handicap National is advocacywith focus on creation of positive attitudes towards children with disabilities. Accordingly, HandicapNational has organized a variety of workshops, exhibitions, radio programs and coffee ceremoniesaimed at raising awareness to prevent disability and its progression. The other component is theprovision of medical rehabilitation services to children with disabilities in cooperation with otherstakeholders. In this regard, Handicap National has been providing physical appliances for thosechildren with physical disabilities and facilitates opportunities for referral services. For this purpose,fieldworkers are assigned to provide home-based therapeutic services for children with disabilities.This rehabilitation component is also coupled with psychosocial support for children with disabilitiesand their parents.Cheshire Services has been implementing comprehensive community based rehabilitation programs.Cheshire has been providing children with post paralysis physical rehabilitation in cases wheresurgical intervention, plaster of Paris and physiotherapy treatments are required for therehabilitation of victims of polio aged 7-15 years. Cheshire Services is also engaged in the productionof orthotic materials to enhance mobility of children and youth with disability including tricycles.Mobile rehabilitation team of Cheshire service Ethiopia provides essential follow up care for disabledchildren and young people in their own localities and looks after more than 6500 patients annually,(January 2008)Ghetnet Metiku WoldegiorgisSocio-Legal ResearcherE-mail: Page 9
  10. 10. Notes on Disability in Ethiopiaproviding them with walking aids such as crutches, braces, orthopedic shoes and walking framestwice a year( in most cases). Through this program 36 outreach locations are being covered in 9regions and administrative councils. Other components of the CBR being implemented by CheshireServices include exercise therapy, awareness raising, economic empowering and offering trainingsfor rehabilitation workers, CBR planners and managers.Save the Children organizations have been actively engaged in awareness raising activities in theirtarget areas. The International Save the Children Alliance has been sensitizing on early childhooddevelopment on Radio Fana which is vital in the prevention of disability. However, the exorbitantfees state media outlets charge has been a stumbling block to the continuity of advocacy work.Therefore, this would require media outlets to give free airtime to programmes meant for awarenesscreation. Save the Children Norway has been undertaking such activities in Chilga and Lay Armachioand other parts of the country. Save the Children UK has also been doing same in Legambo,Mekedella and Debresina weredas of South Wollo as well as weredas 7 and 12 of Addis Ababa. Organization Objectives ActivitiesEthiopian National protecting the human rights of the deaf in registration of the deaf,Association of the Deaf getting equal access to medical care, organizing sporting and(ENAD) education, employment, social and cultural recreational activities, providing life of the society in collaboration with other interpretation services in schools, stakeholders hospitals and courts, awareness raising concerning HIV/AIDS in Addis Ababa, preparation of sign language and providing audiology test at low cost.Ethiopian National provide education and assist persons with runs elementary boardingAssociation of the Blind visual disability in furthering their schools,(ENAB) integration into Ethiopian society; organizes training activities and raise awareness on the situation of people community-based rehabilitations with visual impairment, and programs for blind persons and promote employment opportunities for promotes self-employment visually impaired persons. activitiesEthiopian National attitudinal changes towards persons with provides basic education coursesAssociation of the physical disability by running awareness- and vocational rehabilitation inPhysically Handicapped raising campaigns and advocacy activities the areas of tailoring, agriculture,(ENAPH) leather work and carpentry community-based rehabilitation program focused on psychological rehabilitation of persons with physical disabilities provides them training and employment opportunities.(January 2008)Ghetnet Metiku WoldegiorgisSocio-Legal ResearcherE-mail: Page 10
  11. 11. Notes on Disability in EthiopiaEthiopian National protection of children with mental awareness raising in combatingAssociation for Mentally retardation form from exploitation and discrimination against childrenRetarded Children and abuse, and with disabilities,Youth soliciting support for poor parents of provision of vocational and life children with mental retardation skill training for children with mental retardation, and parenting educationEthiopian National advocating for equalization of opportunities and full participation of personsAssociation for Ex- affected by leprosy,Leprosy Patients awareness raising and bringing about attitudinal changes among the society about(ENAELP) leprosy and persons affected by leprosy, addressing the cultural, social and economical problems of persons affected by leprosy, and networking and collaborating with government and non-governmental organizations to promote studies pertaining to leprosy(January 2008)Ghetnet Metiku WoldegiorgisSocio-Legal ResearcherE-mail: Page 11