Disabled Children & Developing Countries

 

Too often the approach by rehabilitation professionals to the needs of disabled children in developing countries unimaginatively follows protocols designed in the North. Services and equipment are often culturally inappropriate, very costly, and delivered from urban ‘rehabilitation palaces’ far out of reach of the villages and communities where they are most needed. To reach the millions of disabled children who lack the assistance and opportunities they need to realize their potentials, basic skills and knowledge must be simplified and-at least in part-deinstitutionalized so as to make them available at the community and family level.

This new book, with 15 essays by professionals with insight and experience in Third World disability issues, provides a critical basis from which services for disabled children and their families can be planned more appropriately. Its pragmatic but caring approach often challenges the standard protocol. For example, it questions the value of starting a disability program with surveys, quoting WHO:

No country needs to undertake censuses, surveys or registration to find out the needs of its disabled citizens. They are so well known that CBR [community based rehabilitation] can go ahead without question marks. Every dollar spent on further investigation is a dollar misspent. (WHO 1984)

One of the editors of this important book, Pam Zinkin, is a pediatrician and health-rights activist with long experience in the Third World (especially Mozambique). For years she headed the CBR training-of-trainers program based in London, taking care to link the needs of disabled people to

the entrenched inequities facing poor and marginalized people, and stressing the need for fairer, more equitable social structures. A very insightful, warmhearted person with an unwavering commitment to social justice, Pam is the Regional Coordinator for Europe of the International People’s Health Council and is on the International Advisory Board of HealthWrights.

Innovations in Developing Countries for People with Disabilities

 

This important collection of essays explores initiatives in recent years to change how societies view disability. As the Forward stresses, “Most of these changes have been brought about by the continuous efforts of persons with disabilities. Their advocacy for the rights of disabled people has become a strong movement, aligned as it is with the human rights of other marginalized and minority groups.”

With examples from diverse countries and circumstances, the book shows how Community Based Rehabilitation (CBR) programs have pioneered new approaches to more fairly and equitably meet the needs of disabled persons, especially those unserved by institutionalized services. The book is organized in three sections:

1. Foundations,

2. Meeting Needs, and

3. Developing Services.

Many essays in each section focus on the growing role of disabled persons and family members in programs and decision-making affecting disabled persons. Section 1 starts with an discussion by David Werner on “Strengthening the Role of Disabled People in CBR Programmes.” Next is a chapter on “Fostering Parental Involvement” by Pramala Balasundaram of Samadan, describing a parent-run program for mentally handicapped children in a squatter settlement in Delhi, India. Section 2 includes chapters on mobilizing parents/communities in Guyana (Brian O’Toole), in Jamaica (Molly Thornburn), and in Norway (Pål Skogmo), among others. Section 3 starts with a chapter on “Mothers of Disabled Children as CBR Workers” by Barney McGlade and Rita Aquino in the Philippines. This is followed by accounts and planning and evaluation of contrasting CBR programs in Vietnam, Sri Lanka, India and Indonesia.

This book will provide CBR planners and workers with insight into the rich diversity of CBR initiatives, and the importance of leadership and activism by disabled persons themselves.

When Corporations Rule the World

 

In the words of Nobel Peace Laureate, Archbishop Desmond Tutu, this must-read book is “a searing indictment of an unjust international world order.” It provides a very readable, well-documented analysis of the way the dominant model of greed-centered development based on unbridled market forces has widened the gap between rich and poor, and has pursued maximum economic growth (for the rich) at the expense of humanity and the global environment. More important, Korten spells out a moderate but equitable, very rational alternative development strategy, which he calls “People Centered Development” (the title of his first major book).

According to Herman Daly (a senior economist who quit the World Bank in disgust):

Korten is an honest witness to the disastrous betrayal of common people and future generations that is carried out by corporations, governments, and multilateral banks. He cuts through the loud rhetoric of economic growth and global economic integration to the facts of increasing poverty, inequality, and dependence. I hope this book is widely read.

This book is in many ways complimentary to our forthcoming book, Questioning the Solution. David Korten is the founder of the People-Centered Development Forum, based in New York City.

Pictures, People and Power: People-Centered Visual Aids for Development

 

This clear, well-illustrated, do-it-yourself book is about “people-centered visual aids for development communication.” Part 1, titled “Reflection,” compares authoritarian with participatory methods, arguing that the latter are more likely to promote more equal distribution of power among people. Part 2, titled “Action,” provides the nuts and bolts to help community educators and activists design, make and use low-cost people-enabling visual aids. It includes many tips for how to make and use drawings to communicate more effectively.

In the words of the Brazilian educator, Paulo Freire, “People must learn to read their own reality and write their own history.” This book helps people learn to express and interpret their life situations through their own and other’s drawings and art. It includes practical guidelines for facilitators in this graphic, learner-centered process. For community health workers and health educators, Pictures, People and Power will be a welcome adjunct to Helping Health Workers Learn.

Milk, Money and Madness

This lucid, provocative book provides parents and health professionals with information they need to fully appreciate and advise about the importance of breastfeeding and the dangers of bottle feeding to both infant and mother. While it focuses mainly on events in the United States-which has the lowest breastfeeding rate in the industrialized world—the book has global implications. (The US was the only country which refused to sign the International Code advocated by WHO and UNICEF to curb the unscrupulous promotion of breast milk substitutes by multinational corporations.) The disturbing facts in this book are especially pertinent to the Third World, where in some countries the death rate from diarrhea is 20 times as high in bottle fed as in breast fed babies. The book reveals:

• how a product created to help sick children and foundlings was transformed into a powerful transnational industry with revenues of $22 million a day;

• how US taxpayers unwittingly underwrite bottle-feeding by spending over $500 million each year to provide 37% of the infants in the US with free infant formula;

• how the intimate, self-affirming experience of breastfeeding that is responsible for the survival of our species has been reduced to “just one feeding option.”

Naomi Baumslag is Professor of Pediatrics at the University Medical School in Washington, DC, and President of the Women’s International Public Health Network. (Naomi provided valuable advice for the “Killer Industries” chapter of our new book, Questioning the Solution.) Dia L. Michels is a science writer who also co-authored with Naomi A Women’s Guide to Yeast Infections, published in 1992.

Resource Guide to Innovative Health Solutions

This beautifully illustrated, clearly written booklet provides a brief summary of 20 innovative projects supported by Thrasher Research Fund over the last several years. The innovations cover a rich diversity of low-cost solutions to health-related needs. Most utilize local resources and build on indigenous knowledge and skills. The ingenious technologies cover everything from improved solar cookers to passive solar greenhouses; from fermentation of milk as an alternative to refrigeration, to policies and tools to reduce the use of tobacco by children; from hand dug wells and rope pumps to village industries run by micro-hydro power; from Vitamin A fortified rice to iodination of irrigation water.

For more information, with each technology an address is given of a key contact person or program. But perhaps the most important function of this booklet is to trigger the reader’s creative imagination. It presents a challenge not so much to replicate the examples shown, as to create new, more appropriate designs by working closely with the local people.

Among the projects summarized in the booklet is “Village-Based Rehabilitation” in PROJIMO, Mexico. In 1990 PROJIMO received a 3-year grant from Thrasher to develop innovative technologies through a process in which rehab workers and disabled clients work in creative partnership. In cooperation with PROJIMO, HealthWrights is now developing a sequel to Disabled Village Children to be titled Nothing About Us Without Us: developing innovative technologies for, by, and with disabled persons.

Hanyane—A Village Struggles for Eye Health

 

While this marvelous book has been in print for several years, we would like to draw it to readers' attention. A review of this book by Tony Waterston in Postgraduate Doctor—Africa says:

This is the best book about primary health care since that marvelous inspirational book by David Werner, Helping Health Workers Learn. I started thinking it would be a laborious struggle through eye diseases, yet finished it at one sitting-the freshness of the writing and the originality of the approach impels one on. Though intended for health workers dealing with eye diseases, two thirds of the book is equally applicable to community workers from any discipline, in both developed and developing countries…
It is the first part of the book that is such a delight. It is an account in 30 short chapters of how a community nurse builds a community project for eye care with local mothers, using their expertise1⁄4 One understands after reading the book why so many community projects fail (particularly those organized vertically)—yet the rewards of success are so great.

This book relates the true story of how a young nurse, through trial and error, together with villagers evolves an approach to discovery-based learning in which everyone learns together and from one another as equals. It becomes apparent that eye health depends on many factors including good hygiene and nutrition, land rights, equality between men and women, social justice, and ultimately grassroots organizing and creative problem solving. The wide scope, sensitive approach, and gentle but liberating motif of this delightful book is reflected in its expressive line drawings, a few of which are shown on the next page.

War Surgery, Field Manual

…this manual adopts the standpoint of poor and vulnerable communities and staff, caught in wars they did not ask for.

War is still a common event. And tragically, today’s wars kill, injure, and disable many more civilians than soldiers. Land-mines designed to maim rather than kill cause millions of injuries to hapless men, women and children, even long after the fighting has stopped. Recent efforts by the United Nations to ban production and marketing of land-mines have been blocked by powerful nations (China, Russia, USA, etc.) where arms manufacturing for foreign markets is a giant, lucrative business. The voice of peace-makers is muted in an age when corporations rule the world.

“War Surgery, field manual” is a practical, detailed handbook written for surgeons and other medical staff who attend injured people in situations of war. But it contains a wealth of information useful in the management of all sorts of serious injuries, accidental or intentional. It is an indispensable tool, especially for doctors, paramedics, and health workers who work in remote areas far from surgical centers. Hundreds of excellent line drawings by the author make the procedures easier to follow. All medical terms used are explained in a glossary. As far as we know, no other manual covers this information with such depth and clarity. Sadly, the book is over-priced at $100.00, plus postage.

Available from Third World Network, 228 Macalister Road, 10400 Penang, Malaysia.