Defining disability

This definition of disability from a 2014 article, Access to buildings: How People With Disabilities struggle, gave me cause to think:

Disability, according to an online dictionary, is any damage to muscles, nerves, skin, or bones resulting into difficulties in moving about, or performing activities such as dressing, eating, or cleaning.

No definition of disability will ever be complete. There will always be room for improvement. Here is what some persons with disabilities (PWDs) in Uganda had to say (see Poverty and Disability in Uganda 1: Definitions):

• “You are disabled if you are missing any one of your limbs or body parts, or if one of your limbs is deformed”.
• “A disabled person is one who cannot look after himself or herself due to physical or mental limitation”.
• “A person is considered disabled if any one of the senses that were given by God are missing. These may include lack of sight, hearing, touch or reasoning”
• “Disability is when your life is not in your hands - when your physical or mental state is such that other people have to decide for you what to do, where to go, what to eat and who to associate with. You are just an object of pity, and whatever opinion that you give can never be taken seriously. Some people will treat you as if you are a child, even when you are well over 30 years”.

The United Nations Convention on the Rights of Persons with Disabilities defines disability like this:

Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.

The Ugandan Persons with Disabilities Act 2006 gives the following definition:

"Disability" means a substantial functional limitation of daily life activities caused by physical, mental or sensory impairment and environment barriers resulting in limited participation. 

How do you define disabilities?

These are the words I use most on Facebook

It made me happy to see this. These are the words I have used most on Facebook.

When disability is inability

Ugandan legal activist Medi Ssengooba talks about the barriers he and other persons with disabilities (PWDs) face in Uganda.

Medi gives an interesting insight into the way that barriers prevent PWDs from achieving their full potential. In the United States he was able to study in a barrier free environment and live independently - he was a straight 'A' student. By contrast in Uganda he was dependent, needed help and could not access libraries, toilets, classrooms and other facilities - he was a mediocre student.

If you are a PWD in Uganda, and you can't get to America to study in a barrier free environment, you will always be undervalued.

This short clip illustrates that disability rights are a moral issue. Receiving your rights means you get the selfesteem and self worth that are your entitlement. 

Human Rights

Human dignity is the basis of human rights law. Article 1 of the Convention on the Rights of Persons with Disabilities states:

The purpose of the present Convention is to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and to promote respect for their inherent dignity.

This blog has shown that disability is viewed as a curse in Uganda. Time and again persons with disabilities (PWDs) have told about the stigma and prejudice they face. If you accept that disability is a curse then you make stigma and prejudice acceptable; you take away human rights and human dignity.

Due to poor hygiene conditions characterized by dirty and inaccessible toilets in local schools has led to school dropout and infectious diseases among pupils with disabilities

Disabled people have the same rights as everyone else. Disability is a natural part of human diversity.

Education and poverty

Eradication of poverty is a driver for getting people educated. Even small gains in education have important benefits on reducing poverty (see The Uganda Poverty Assessment Report 2016). Education should therefore be a priority for persons with disabilities (PWDs).

Is inclusive education available for children with disabilities?

Ableism

Ableism is the conscious or subconscious behaviors that assume that able is the norm. Ableism asserts that persons with disabilities (PWDs) should try their hardest to fit into an able society.

Ableism views disability as an error in life that is inferior, it devalues and negates the experiences of PWDs.

Disability is not a curse, it is a simply a consequence of human diversity.

Look beyond the disability

The Social Model of Disability

People with disabilities (PWDs) have impairments. The impairments have an impact on the life of a PWD. However it is not the impairment that makes someone disabled.

PWDs are disabled by the world around them and the barriers they encounter. If the barriers were removed the world would be more accessible. PWDs would have only their impairments.

Barriers are things like:

• Peoples attitudes
• Stairs in stead of ramps or lifts
• No braille signs
• No sign language interpreters
• People that don't understand your disability

When you understand that you have impairments, you can begin to get barriers removed.

Stigma is the greatest barrier for a person with a disability

The greatest barrier a person with a disability (PWD) must face is stigma.

The diagram below shows the connection between stigma, disability and poverty. Both cycles depict negative feedback systems.

Poverty and disability are higher for PWDs than those who do not have a disability

1 in 5 people in Uganda has a disability

What should everyone know about disability in Uganda?

1 in 5 persons in Uganda has some form of disability. This has been known since 2006. 

The current population of Uganda is estimated to be 40,965,921 (see Worldometers: Uganda Population (LIVE)). One fifth of the population, that is 20%, has a disability. 

There are 8,193,184 persons with disabilities (PWDs) which is almost 2 times the population of my home country New Zealand (4,583,129 see Worldometers: New Zealand Population (LIVE)).

Four Case Studies

Happy International Day of Persons with Disabilities

Happy International Day of Persons with Disabilities (IDPD) from everyone at Disability Support Uganda.

Education in Uganda: High Dropout Rates

Dropout rates from school are an important issue for persons with disabilities (PWDs). Several blog posts in the DiSU blog have mentioned dropout rates:

• Poverty: Because of poverty, "Students from low-income families are 2.4 times more likely to drop out than middle-income kids, and over 10 times more likely than high-income peers to drop out".
• Education and Disability: Uganda and the World: In Uganda, dropout rates are lower among children with visual and physical impairments than among those with mental impairments.
• Education and Disability: An Alternative Report to the UNCRPD: The 2009 Foundation for Human Rights Initiative (FHRI) report cited rampant dropout rates of PWDs. It noted that many disabled children fall behind, and discouraged by repeated failure, dropout of school. 
• Education and Disability: Uganda: A lack of accessible information in schools has been indicated as one of the reasons for high dropouts in school and poor literacy rates for PWDs, resulting in limited employment opportunities.

What is the Ugandan perspective on children dropping out of school? In his 2014 thesis The realisation of human rights for disabled people in higher education in Uganda: a critical analysis drawing on the UN Convention on the Rights of Persons with Disabilities Paul Emong discusses the high rate of dropouts in relation to other statistics. Emong begins looking at over all statistics:

Uganda‘s population is estimated to be 34.1 million. 7.2% of it, according to Uganda National Household Survey (UNHS) 2005/2006, is disabled people. The UNHS statistics show a significant percentage increase of disabled people from the National Population Census Report 2002 which stated that disabled people were 3.45% of the population. The increasing proportion of disabled people appears to be a global development. The World Report on Disability 2011 indicates that 15% of world population is disabled people. This is more than the long known estimates that 10% of the world population is disabled people.

Arguably, with specific reference to Uganda, given that the major disabling diseases such as polio have almost been eradicated and majority of the population been young people, the percentage margin between the Survey and Census statistics does not necessarily mean an increase in the population of disabled people, but rather an indicator of positive developments regarding disability inclusion in the country. For example, it implies a growing awareness of what disability is and also people are willing declaring that they have a disability, a sign of possible reduction of stigma on disability. It also shows that, some human attributes that were not thought to be a disability are now being considered a disability in Uganda. The albinos and little people are classic examples. These groups gained recognition as disabled people around mind 2000s when National Union of Disabled Persons of Uganda (NUDIPU) accepted them to be disabled people. The albinos and little people demonstrated that they are facing stigma and social exclusion a similar way like any other category of disability. The recognition of albinos and little people as disabled people is example that disability as a diverse and as well as an evolving concept. Another significant development that can be associated to this statistics is that the data collection tools by the National Bureau of Statistics (UBOS) are now updated to capture disability as diverse concept. This may further imply that overall; there is growing disability awareness in the Ugandan public sector, a significant sign that, the country is moving forward to recognising disability as a social, a human rights and a development issue.

However, in Uganda, it appears that the increasing awareness about disability is not reflected in education. If it is reflected, then, what disability discrimination means in education is lacking. To support that observation, I draw statistics on two indicators in education, namely literacy levels and school dropout rate. On literacy levels, evidence form statistics suggests that, the illiteracy levels among disabled people are higher than those who are not disabled. Because, the overall literacy rate in Uganda among children aged 10 years and above were 73% in 2009/10,8 yet 50% of disabled people in Uganda have not attended primary and secondary school at all. Implying that, more than 50% of disabled people are illiterate. The second observation is that, the dropout rate of disabled pupils at every level of education is higher than those pupils without disabilities. This is illustrated by comparing the percentages of disabled pupils who progressed from primary seven (P.7) to secondary level of education with the overall percentage of pupils who also progressed from P.7 to join secondary, using education statistics presented by the UBOS Statistical Abstract 2006 to 2010. The percentages are my own computations.

• In 2006, there were 468,436 pupils in their last year of primary education (primary seven –P.7), in 2007, those who joined secondary one (S.1) were 277,95011 i.e. 59% progressed to S.1. Implying that, 41% of the pupils who were in P.7 did not join S.1. For disabled pupils, in 2006, there were 12,855 disabled pupils recorded in P.7;12 in 2007, those who joined S.1 were 2,99013 i.e. 23% progressed to S.1. This implies that, nearly 77% of disabled pupils did not progress to the secondary level of education.15
• In 2007, there were 470,272 pupils in P.7; in 2008, those who joined S.1 were 291,797 i.e. 62% progressed to S.1.16 Meaning that, 38% of pupils did not make it to S.1. For disabled pupils, in 2007 there were 11,632 in P.7; in 2008, those who joined S.1 were 2,83018 i.e. 24% progressed to S.1. Meaning that, 76% of disabled pupils did not join S.1.
• In 2008, there were 515,729 in P.7 and those who joined S.1 in 2009 were 296,400 i.e. 57% progressed to S.1. Meaning that 43% of the pupils did not make it to S.1. For the case of disabled pupils, in 2008, there were 12,000 in P.7; in 2009, those who joined S.1 were 3,275 i.e. 27 progressed to S.1%. Meaning that, 73% of the disabled pupils failed to join S.1.
• In 2009, there 546,505 pupils in P.7 and in 2010 those who joined S.1 were 324,48724 i.e. 59% progressed to S.1. Meaning that, 41% of the pupils did not make up to S.1. For the case of disabled pupils, in 2009, there were 13,302 in P.7; in 2010, those who joined S.1 were 3,20825 i.e. 24% progressed to S.1. Meaning that, 76% of disabled pupils did not join S.1.

From the comparisons above, it can be concluded that less than 25% of disabled pupils in P.7 will join S.1. And, overall, about 60% of pupils in P.7 will join S.1. This means that, there is high school dropout rate among disabled pupils as compared to rest of the pupils and reflects the extent to which Uganda fails to ensure non-discrimination of disabled pupils in education.

To put the exclusion of disabled pupils in education in context, it is important to view it within the larger contextual factors surrounding the realisation of education as a right in Uganda as that helps to examine the extent to which the educational facilities can be made accessible and adaptable for every category of disabled people. In Uganda, it can be stated that about 70% of pupils that start primary education do not complete it (do not reach P.7). For the case of disabled pupils, it is about 75% of those who enrol in P.1 do not complete primary level o education. The tables below illustrate it.

Table 1: Showing the overall number of pupils recorded in primary one from 2001 to 2006 compared to those who completed primary education.

Year registered in P1	Number of Pupils	Expected Year of Completion of P7	Number of Pupils who sat P7	Percentage Dropout Rate
2001	1,704,766	2007	470,272	72
2002	1,847,160	2008	515,729	72
2003	1,914,893	2009	509,640	73
2004	1,837,277	2010	544,531	70
2005	1,712,420	2011	535,933	69
2006	1,763,284	2012	564,804	68

Table 2: Showing the number of disabled pupils recorded in primary one from 2002 to 2004 compared to those who reached primary seven.

P1	Number Children with Disability	P7	Number of Pupils with Disability	Percentage Dropout Rate
2002	48,063	2008	12,000	75
2003	51,965	2009	13,302	74
2004	44,866	2010	12,871	71

There is no authoritative empirical evidence from government why there is high school dropout rate at primary. What exist are reports by NGOs and government inquiries on the running of primary education providing some explanations on this matter. According to these reports, the causes of high school dropout rate in the country include: Inflation of enrolment figures by schools with a view of getting more government funding, this means that the number of ghost pupils is highest in P1 and lowest in P7; pupils study on empty stomachs as no provision for food on government budget and parents also do not fill this gap and this makes some dropout of school; early marriages, a common practice in Uganda; some are repeating some classes along the way and lack of adequate sitting space. But these also appear to be providing hypothetical reasons, thus, calling for a major government inquiry into the matter.

To disabled pupils, additional factors such as attitudes and knowledge, different opinions about disability inclusion and accessibility requirements also affect their education. This could explain the fact that, in Uganda, despite the emphasis of education policies on inclusive education and an established structure for training teachers in special needs, attaining inclusive education has remained a challenge. Because of such tangle of factors in education, Uganda is unable to meet the educational needs for disabled people so as to provide them education without discrimination and on the basis of equal opportunities.
In broader perspective, this situation is not only limited to Uganda, but it is seen across many developing countries. Globally, despite general increasing enrolment in schools i.e. 86% of children get primary education, disabled people are still largely excluded. It is therefore, feared that fewer than 5% of disabled children are believed to reach the Education For All (EFA) goal of primary school completion and 40 million out of 115 million children (35%) out of school are disabled children. The most excluded are those with intellectual disabilities as they have not gained access to higher education.

Youth with Physical Disabilities Development Forum (YPDDF) trains parents on the importance of educatiing children with disabilities in an inclusive environment

Why do children dropout of school? Consider this article, consider the attitudes of these parents. To dropout these CWDs need to get to school. Despite there being laws and policies in place for the protection of the vulnerable, CWDs still face woeful inadequacies this 2013 article Denied a right to play reports:

Orphans and Vulnerable Children’s policy a mixed Grill: When Gorreti Kisa caught malaria one evening in 2005, her parents instinctively rushed her to a clinic near their home in the city suburb of Kalerwe. But a well-intended move turned into a nightmare as she has since been condemned to spend the rest of her life disabled.

“The clinic attendant gave her an injection, but it seems it wasn’t the right prescription,” says George Bizimana, Kisa’s father. “Her left buttock got swollen and the problem spread to the leg.”

For over half a year, Kisa was taken to almost all hospitals around Kampala, but it all came to nothing. Even when she healed from malaria, the leg remained unstable. It slimed and Kisa could only walk with the help of a stick.

Eight years later, Kisa, 13, sits at the verandah, looking down as she plays about with her walking stick. When I attempt to take her picture, her father sternly refuses, saying we would be subjecting her to ridicule from readers.

“People have seen her enough and scorned her enough. I will not allow you to take her picture,” says Bizimana.

Perhaps the father is right; neighbourhood parents have already made their verdict.

“Even people here don’t allow their children to play with her,” Bizimana says.

Kisa is a portrait of thousands of Children with Disabilities (CWDs) who live in isolation, denial and scorn from those around them. Daily Monitor recently reported about Lisa, a 14-year-old who spends her entire day tied to a tree. Lisa’s ‘crime’ is that she is deaf and can’t feed herself.

Lisa and Kisa are disabled, isolated and have had their share of the public ridicule. Ben Waburokho, an official at the Uganda Child NGO Network (UCRNN), says it is not just these two. He says thousands of CWDs are being hidden in bedrooms, regarded as a source of shame.

“Those who hide them say they (CWDs) cause shame to the family and a solution is to keep them away from public,” says Waburokho.

But all this is against the UN Convention on the Rights of People with disabilities, to which Uganda is signatory. Article 7 of the convention urges state parties to take all necessary measures to ensure that children with disabilities fully enjoy all human rights and fundamental freedoms on an equal basis with others.

Indeed, when the 2004 Orphans and Other Vulnerable Children (OVC) policy was adopted, many thought that challenges affecting vulnerable children would disappear.

That optimism was understandable. While the policy doesn’t mention CWDs but categorises them in general under the vulnerable children, its provisions appeared strong.

Vulnerable children should have access to education and health; should not be discriminated, impoverished, or regarded not as helpless victims. They should be treated as actors in their own right.

While a number of policies, like the Special Needs and Inclusive Education policy (2011) and the Universal Primary Education policy, have been put in place to supplement the 2004 OVC policy, progress is scanty.

Edson Ngirabakunzi, executive director of the National Union of Disabled persons of Uganda (Nudipu), says that there is commendable progress in areas like access to education and the health of persons with disabilities.

“We must accept that at least the government has done something. And we must agree that a lot needs to be done as well,” says Ngirabakunzi.

But issues such as discrimination, poverty, abuse and neglect have remained a baffling factor. Research shows that many CWDs have been abused sexually – with underage girls being impregnated while the perpetrators remain at large.

Official figures from Nudipu show that people with developmental disabilities are four to 10 times more likely to be victims of crime than able bodied people. Worse still, the vast majority of abuse toward those with disabilities is perpetrated by family members, peers or professional caregivers.

“There is still a long way to go, especially in terms of empowering the PWDs to fight perpetuators of crime on them,” says Ngirabakunzi. “They don’t have the ability to defend themselves. They just remain at the mercy of the abusers and it is unfortunate that the abusers walk free.”

He adds that Uganda’s biggest problem is not policies and laws, many of which are good, compared to other countries; the problem is implementation. CWDs face multiple suffering given the additional costs they have to incur to meet their needs. For instance, if CWDs are going to school they have to incur an additional cost for special scholastic materials. Many can’t afford these, which explains why the school dropout rates for CWDs are very high.

Official figures show that 90% of the PWDs don’t go beyond primary education, with only 2.2% said to have attained post-secondary level of education.According to Martin Kiiza, the secretary general of the National Council for Children, government achievements in protecting vulnerable children shouldn’t be underestimated. Kiiza says the government is a signatory to international conventions committing it to protect children sends a clear signal that there are inherent efforts to protect children.

“First, the 2004 policy is a guiding tool for advocacy. It is a guiding document that is supposed to inform laws and what should be implemented,” says Kiiza.

“The government has very much done some work. It ratified the UN convention, put in place institutions like National Council for Children (NCC), ministry of Gender and Labour Development – all advocating for children rights and protection in whatever state they are in,” Kiiza argues.

Paper tiger: Yet when pressed, Kiiza concedes that there is a problem when it comes to implementing child friendly policies.

“Implementation is still our biggest challenge. The benefits of all these policies have not trickled down to the local people that these policies are supposed to benefit.
“That’s why for instance materials that the disabled children use are still so expensive and many can’t continue with school. As NCC, we are determined to see that all materials used by the CWDs in school are subsidized this year,” says Kiiza.

Led by NCC, about 150 disabled children presented a petition to the speaker of Parliament last year asking the government to address their issues. They protested the violation of their fundamental rights.

Among other issues, they cited the lack of respect for them from the family, communities and fellow children – as a result, the disabled children do get the care and protection they are entitled to like children.

All this happens despite the existence of the 2004 OVC policy. With the petition to Parliament, the children were telling the powers that be that “you are letting us down”. It remains to be seen if MPs can do something to more effectively help children like Lisa and Kisa to come out of their isolation and discrimination.

In Uganda, around 70% of pupils starting primary school will not complete their education. This alone is an enormous problem. Figures for children with disabilities (CWDs) are scanty. It is questionable whether all CWDs entitled to education start P1. Emong estimates that the number of CWDs attending school may be as low as 10-20%. This surely is a scandal and a vast human rights crime.

Changing Attitudes to Disability in Uganda

This is a short film about the rights of persons with disabilities (PWDs) in Uganda. It discusses the work of lawyers that are fighting to make buildings accessible, and also get TV channels to have sign language for important news bulletins. The film asks: What is the value of a PWD? What are the rights of PWDs?

This is a joint project of the Open Society Initiative for Eastern Africa (OSIEA) and the Open Society's Disability Rights Initiative (DRI). The Disability Rights Initiative promotes national implementation of the UN Convention on the Rights of Persons with Disabilities (CRPD).

Does this video prove that disability is not inability?

According to the social model of disability persons with disabilities (PWDs) are disabled by barriers that are are created by the environment, culture or society they live in (see The Social Model of Disability: Education in Uganda). When these barriers are removed: Disability is not inability. Is that correct?

Does the man in this video face barriers because of his disability? Does he prove that "disability is not inability"?

At the end of this video the reporter concludes with a negative stereotype: 

"It is very common that many people with disability wallow in self pity." Is this statement accurate or is this another example of the social barriers that PWDs face?

Finally: 

Does this video represent a barrier to access?

The poster says about this video: 

A man in Kampala has stunned many of his peers by living his life to the fullest despite his disability.
Robert Tuhamire is a graduate of Business Administration who’s leading a life that’s the envy of many. Gertrude Tumusiime Uwitware has that report in this weeks “Living Life” feature.

Education and Disability: Uganda

The blog post Disability and Education: Uganda and the World gave a brief overview of some statistics about education and disability. It situated Uganda in the worldwide and particularly African context. This blog post will discuss the education of children with disabilities (CWDs) in Uganda.

The 2013 report ACCESS TO EDUCATION BY PERSONS WITH DISABILITIES IN UGANDA’S EDUCATION SYSTEM says that giving more people an education is an important way of tackling poverty. Eradicating poverty is a great driver for getting people educated.

Uganda is a signatory of the United Nation Convention on the Rights of Persons With Disabilities (CRDP), (see Do you know your rights?) The Ugandan government has used the CRDP as the basis for its laws. It is said that Uganda has some of the best human rights legislation in the world and particularly in Africa (see 2014 report Uganda’s disability journey: Progress and challenges). The 2009 International Labour Organization (ILO) report Inclusion of Peoplewith Disabilities In Uganda cites some of this legislation that is important for PWDs:

• The Constitution of Uganda, 1995. Article 21 prohibits discrimination against PWDs. Uganda is one of the few countries in the world to recognize sign language in its Constitution.
• The PWDs Act, 2006, makes provisions for the elimination of all forms of discrimination against PWDs and works towards equal opportunities. Also provides for a tax reduction of 15 per cent to private employers who employ ten or more persons with disabilities either as regular employees, apprentice or learners on a full time basis. 
• The Local Government Act, 1997, Parliamentary Elections Statute, 1996, and the Movement Act, 1998. These laws aim to increase the representation of disabled people in the public sphere. The Local Government Act, for example, provides for representation of disabled people at the various Local Council levels. In addition, Section 37 of the Parliamentary Elections Statute provides for five seats in Parliament for representatives of persons with disabilities. 
• Traffic and Road Safety Act, 1998, prohibits denial of a driving permit on the basis of disability. 
• Uganda Communications Act, 1998, provides for the promotion of research into the development and use of new communications techniques and technologies, including those which promote accessibility of hearing-impaired people to communication services. 
• Workers’ Compensation Act, 2000, provides compensation to workers who are injured or disabled through industrial accidents. 
• The National Council for Disability Act (No. 14), 2003, monitors and evaluates the rights of PWDs as set out in international conventions and legal instruments, the Constitution and other laws. 
• The Business, Technical, Vocational Education and Training (BTVET) Act, No. 12, 2008, promotes equitable access to education and training for all disadvantaged groups, including disabled people. 
• National Policy on Disabilities, 2006, provides a human rights-based framework for responding to the needs of PWDs. 
• The Equal Opportunity Act, 2006, and the Employment Act (No. 6), 2006, both prohibit discrimination of persons in employment based on disability.
• The Universal Primary Education Act, makes it financially possible for families to send their disabled children to school by providing free primary education to four children in every family, including disabled children. 
• The Uganda Vision 2025 and the Poverty Eradication Action Program (PEAP), provide a long-term development framework and initiatives aimed at sustaining rapid economic growth and tackling poverty.

The state of ACCESS TO EDUCATION BY WOMEN & GIRLS WITH DISABILITIES: THE CASE OF UGANDA cites the following legislation that is of importance to women and girls with disabilities:

• The Constitution of the Republic of Uganda (1995)
• National Education Policy 1992
• The Persons with Disabilities Act (2006)
• The Universal Primary Education policy (UPE) and Universal Secondary Education policy (USE)

The 2014 report Uganda’s disability journey: Progress and challenges highlights the following legislation as important for Persons with disabilities (PWDs):

• The 1996 Children’s Statute for early assessment of disabilities amongst children to achieve early treatment, rehabilitation and education.
• The Parliamentary Elections Statute of 1996 established five positions in parliament of which one of them must be a woman, and recognised the use of sign language for the deaf in parliament.
• The 1997 Local Government Act that established representation of PWDs at all local government levels for both males and females.
• The 1997 Uganda Communication Act for the development of techniques and technologies to ensure communication services for PWDs and the 1997 Universal Primary Education (UPE) Act which demands families to give CWDs priority at enrolment.
• The 1998 UNISE Act, for the establishment of the Uganda National Institute of Education (UNISE) for special teacher training for CWDs.
• Others include the special allocation of university scholarships for persons with disabilities through affirmative action and the right to assets including land.

These laws provide a formidable framework for upholding the rights of disabled people in Uganda. The 2013 report ACCESS TO EDUCATION BY PERSONS WITH DISABILITIES IN UGANDA’S EDUCATION SYSTEM details the current situation as it is known in Uganda:

Since the implementation of the UPE initiative in 1997 and the introduction of Universal Secondary Education (USE) in 2005, the number of primary and secondary school age children accessing education has gone up. According to statistics collected by UNICEF between 2000 and 2007, the literacy rate in Uganda stands at 74% and enrolment into primary school stands at 82%. In terms of gender, the rate stands at 84% for girls and 88% for boys. For school age children with disabilities, the Uganda Population and Housing Census (2002) found that they rarely access education. Statistically, children with disabilities out of school were four times higher than those in schools. Although the census was conducted before Uganda signed the CRDP, these figures still reflect the enormity of the task ahead and the importance of making structural and legal changes to improve access to education for children with disabilities. Given the high number of children with disabilities not accessing education, it is not surprising that the census found that only 2.2% had obtained a post secondary level education.
The 2006 Uganda National Household Survey found that nearly 90% of children with disabilities do not obtain post primary education and 60% fail to receive primary school education. In terms of population numbers, based on the 2008 figures provided by the Ministry of Education and Sports, there are 183,537 disabled children in primary schools and 11,145 in secondary schools in Uganda. The poor statistics clearly reflect the consequences of under investment and a lack of structural changes to improve access to education for persons with disabilities. Having signed the CRDP and made a number of legal reforms to effect the requirements of the Convention, empirical studies are needed to measure the impact of these reforms on the high number of children with disabilities who have no access to education in Uganda.
Although literacy and numeracy is on a sharp rise in Uganda, it has done little to curb traditional beliefs and superstitions. Access to education for persons with disabilities continues to be blighted by fear of stigma. It is still considered unholy or a curse to give birth to a disabled child and those who suffer mental health illness are often taken as possessed or bewitched. This has enabled traditional healers to earn a living from those who come to their aid. Traditional beliefs and stigma have driven many relatives of children with disabilities to hide them away from society. A 2009 report by the Foundation for Human Rights Initiative (FHRI) found that of the 30 school children with disabilities in Paipir Primary School in the district of Kitgum, 27 of them were enrolled in school on a humanitarian basis by Non-Governmental Organizations (NGOs) after finding them in their communities. This highlights the scale of disregard for the right of persons with disabilities and the degree to which stigma and traditional beliefs affect their ability to access education.
In addition to stigma and traditional beliefs, poverty and social exclusion remain key barriers to accessing education. Even though the UPE and USE initiatives have eliminated 90% of the educational costs for the students, a lack of adequate mobility devices such as wheelchairs, which in most cases the students pay for themselves, has been a barrier to education. Thus, it remains more expensive to educate a physically disabled child. For children with mental health disabilities, factors such as transportation and general well-being require additional funds which in most cases come out of their relative’s pockets. For students with mental illnesses, community rehabilitation is often available but it is rarely provided given the social stigma associated with mental illness. It still remains that persons with physical disabilities are more accepted in society than those with mental disabilities. 

The 2014 report Uganda’s disability journey: Progress and challenges notes, that there is a shortage of reliable research data on disability in Uganda (see Education and Disability: Uganda and the World). The report takes up the discussion of the rights based approach for solving disability problems, that is having a robust frame of laws to support basic human rights:

The human rights based approach to disability in Uganda highlights the importance of attaining the full potential of persons with disabilities in both physical and mental terms. However, implementation of interventions that would ensure this has been slow or non-existent. Research in Uganda has indicated limited use of accessible information especially within education and health service provision (Action on Disability and Development Commissioned Study 2005; Lang & Murangira 2009). Examples of accessible information include sign language, and the use of electronic communications aids that allow the user to picture symbols, letters, and/or words and phrases to create messages (American Speech-Language-Hearing Association 2014). Within the education sector, most mainstream schools do not provide accessible information and PWDs admitted to higher education institutions may have to pay out of pocket for any communication service they need (Foundation for Human Rights Initiative 2009; Murray n.d.). A lack of accessible information in schools has been indicated as one of the reasons for high dropouts in school and poor literacy rates for persons with disabilities (Lang & Murangira 2009; World Bank 2009), resulting in limited employment opportunities. The limited number of accredited educational institutions for training in accessible information exacerbates the problem, making it impossible to meet the demand for such services in Uganda; as a result, CWDs lag behind (Republic of Uganda 2006). Likewise, ensuring adequate availability of assistive technologies for mobility is important since such technologies have been found to create greater community participation in Uganda, especially in education and employment (Hunt et al. 2004).
On the other hand, government efforts towards inclusive education have often been criticised and accused of putting children with disabilities amongst able bodied children without adequate modifications to the teaching and learning environment, and with inadequate specialised teachers (Foundation for Human Rights Initiative 2009:15, 19). Similarly, when universal primary education was first introduced, there was a large influx of previously excluded groups of children, including those with disabilities. With few additional resources schools were overwhelmed and reported problems with discipline, performance, and dropout rates amongst students (World Health Organization & World Bank 2011).

 The 2013 report ACCESS TO EDUCATION BY PERSONS WITH DISABILITIES IN UGANDA’S EDUCATION SYSTEM sums up the position of PWDs as follows:

Having examined the developments made to the education system in Uganda and the motivations behind these reforms, it is clear that a lot of progress has been made since 1986. The government has done a remarkable job in promoting the right to access primary and secondary education. The removal of school fees under the UPE and USE initiatives is a remarkable but abrupt change to a system that has often been underfunded and under-resourced. Although these policies were put in place before signing the CRDP, since becoming signatory, new legislation and policies have been passed to expand and safeguard the rights of persons with disabilities in education. These reforms have helped to promote inclusive education by removing the financial barriers and putting in place legal safeguards for disabled persons. However, inclusive education requires continued financial commitment which the Ugandan government has so far failed to do. Furthermore, there is a general lack of facilities and resources for children with disabilities in schools and colleges, and even universities. Thus, even though legal reforms have been made, little has been implemented which means that many school age children with disabilities continue to be denied the right to education.
The battle between traditional beliefs and modern medicine or practices is also being fought on all fronts. Given that modern medicine and practices are starting to win the battle, credit should go to the Ugandan government for expanding literacy for girls and boys, and promoting inclusive education through educational policies and initiatives. However, the lack of adequate enforcement has reduced their effectiveness.
Given the high ratio of students per classroom, new infrastructure and structural reforms need to be made to improve learning in public schools. This ratio coupled with poor pay for teachers is beginning to create a gap in the standards between private and public schools since the best teachers are being driven out of public schools into private ones. Thus the government must aim to build more schools, increase teachers’ pay and improve infrastructure in schools. For PWDs, wholesale changes need to be made in relation to infrastructure, accessibility and strong enforcement of policies that deter disability discrimination. 

Changing lives through education

What is it like to get an education in Uganda. The experiences of James Makula who had a polio attack at the age of 3 are described in I crawled to school for six years. Makula is a commercial officer at the Ministry of Trade, Industry and Cooperatives:

At the tender age of three years, Makula and his friends were playing outside his family home in Kanisa zone in Makindye Division when something strange happened. Makula suddenly fell to the ground and began convulsing.
Upon hearing loud screams, Alice Ndagire, his mother, who was inside the house doing chores rushed outside and ran towards her son.
Once by his side, she continously tapped him as a way of resuscitating him. She noticed his body slowly folding and resorted to straightening it.
When that did not help, she picked up her son and rushed him to Mulago hospital. Makula's condition was diagnosed as a polio attack despite the fact that he had been immunised before.
Born to Alice Ndagire and Leonard Makula on November 21, 1976, Makula was raised by a single mother, his father having passed away in 2002.
Disfigured and unable to stand and sit well after the Polio attack, the severity of Makula's disability did not become clear to the family until he was eight years of age.
"At the time, I had started studying but then unlike other children who would walk to school, I would instead crawl, sometimes with my buttocks on the ground. I had to do this unaccompanied every day for six years from Primary One to six while covering a distance of about two kilometres to school and back home," Makula says.
"Some of the children who would find me on the way often said mean things including omulema (the lame one) and by then, such a phrase was regarded as an insult."
Makula was then at Kibuye Primary School, a day learning facility, located in Makindye Division. The name calling and the occasional bullying was what discouraged Makula from going to school sometimes.
"There are days I would wake up and tell my mother that I was not going to school. She would then cane me until I agreed to go. Her reasoning was that my disability should not deter me from getting an education," Makula says.
His school uniform was a white shirt and khaki shorts. When it rained, the attire was often plastered with brown muddy stains and the shoes soaked with water.
Turning point: The school administration was, however, considerate to let him study in such a state. Rotary Club of Makindye came to his rescue and donated a wheel chair as he was starting Primary Seven.
Amid the challenges, Makula focussed on attaining good grades and it is no wonder that he scored four aggregates at Primary Leaving Examinations (PLE).
His good grades automatically qualified him to get a placement at Namilyango College, a boy's only Secondary boarding school in Mukono District. His stay there was, however, short-lived after the school administration considered him unfit after just one term.
From Namilyango College, he then joined St Peters Senior Secondary School, Nsambya, where he continued with Senior One from second term up to the third term of Senior Two but left because the school did not have an established science class including a laboratory. For his Senior Three and Senior Four, he went to Lubiri Secondary School in Rubaga.
Then, for A-Level, Makula studied at Busoga College Mwiri in Jinja District.
Life at Mwiri: Boarding school life at Mwiri came with its own share of challenges, says Makula.
"It was tough in that I always had to wake up earlier than the rest of the students to bathe and prepare myself for class so as not to use my disability as an excuse for being late for morning preps. And since the school administration had learnt how to accommodate me, they got me someone to push me to class in my wheelchair."
Makula's helper was a young boy, aged 17, a relative of one of the school cooks.
Other than that, Makula says that what also helped him cope easily was his friendly personality. It is no wonder that it was easy for him to get fellow students to help him out with tasks from time to time.
"One of those boys who assisted me a lot was called Grace Kyagaba to the extent that other students thought we were brothers," Makula says.
It is people like Kyagaba who made his stay in Mwiri worthwhile.
On whether they still keep in touch, Makula who was then studying a combination of Physics, Chemistry and Maths responds in the negative.
"I absolutely have no idea where my former friend is. I did not see him again after completing our Senior Six examinations," he says.
Life at University: Makula's other life chapter started in 1998 when he was admitted at Makerere University to pursue a Bachelor's degree in pharmacy. The enthusiasm he had to study the course, however, dwindled when other students in higher classes taking the same course brought him up to speed with the challenges he was likely to face if he decided to go ahead and study it.
"I was told that there were instances when I would be required to carry out experiments on viruses and bacteria and because I was not physically fit, I would end up making a mistake including doing spills and this would endanger my life. But also, the course involved a lot of movements in and out classrooms and laboratories and my disability was a sort of setback," Makula says.
Change of course: Rather than feel sorry for himself, he changed to study a Bachelor of Science in Quantitative Economics.
"I never attended classes because they were always held upstairs, in storied buildings. I would instead wait outside the class to ask for notes from colleagues. Some would give me while others made excuses that they were going to read," he says, adding, "On other days though, I would get someone to push me around to different hostel rooms at the university looking for classmates to give me notes.
Life was so difficult to the extent that the lecturers let me do my tests outside the lecture rooms."
Despite the challenges, he focussed on accomplishing his goal of finishing his three years at the university and he graduated in 2001.
The job market: It is tough for persons with disabilities to get employment because of the perception towards them.
Makula was always shunned at job interviews to the extent that he was always questioned on what he was doing there in the first place.
But even during instances where he was allowed to sit for them and actually passed, he was not given the job.
"There was a particular incident where I was even told to go and work in an organisation for persons with disabilities because I would not manage the organisation's work. I tried to tell them over and over again that I could handle but they did not listen," he says.
Having failed to get permanent employment, Makula resorted to doing a few contract projects for a chargeable fee as a way of making ends meet.
He worked for Action on Disability and Development (ADD) International for six months in 2005 as a social worker, Uganda National Action on Physical Disability (UNAPD) for eight months as a research officer in 2008 and then Parliament of Uganda for one year, still as a research officer for persons with disabilities in 2006.
Then in 2014, he came across a job advertisement from the Ministry of Trade, Industry and Cooperatives for the position of commercial officer. More than 15,000 people applied and went through a vigorous process of both oral and written interviews.
"It was such a competitive position in that I could not believe it when I was eventually informed that I got the job," Makula says.
Other than that, the 39-year-old says that there is no discrimination at the workplace and management is very understanding to the extent that they got him a helper to push him around the building, accompany him to workshops as well as help him out with other tasks.
Makula's job entails examining policies and laws that are trade-related, monitoring conditional grants to districts as well as handling applications for licenses by non-citizens.
How he gets to work: A motor cycle transports him from Nsambya, a suburb of Kampala, to the Ministry's offices located along Parliamentary Avenue. It is the same means he uses to get back home after work in the evening.
In order to avoid inconvenience, Makula leaves his wheel chair at his workplace.
Whenever he arrives outside the office premises in the morning, the helper at work pushes it to where he is.
Eventually, he helps Makula into it and then wheels him to his office located on the third floor of the building using an elevator. The aide does the same thing after work.
Normally, Makula calls any random boda rider on the roadside to take him home.
Home life: Makula laughs and suddenly avoids eye contact when I ask him if he is dating or married.
"It is not very easy for women to accept men in my state. It is the reason I do not have a wife or girlfriend. However, I am optimistic that one day, I will get one," he says.
He does house chores by himself including washing clothes, cooking and ironing, among others.
He moves around the house by crawling.
Makula concludes that life will only get much better when he gets a family of his own.
Polio and immunisation? Dr Vincent Karuhanga, a physician at Friends' Poly Clinic in Kampala says:
"It is possible to get a polio attack even after immunisation, especially if a child has a low immunity as a result of diseases including cancer and HIV/ Aids.
"But also, if the vaccine has been kept in poor storage conditions, its use may not be that effective once it is administered to a child. It is, therefore, advisable that parents take their children to recognised health institutions to have their children immunised. But also, parents are advised to embrace the mass immunisation exercises that the Ministry of Health carries out from time to time regardless of whether a child has been immunised or not. There is also a booster dose that can be given to children before they enrol for primary school."
Makula's advice to other persons with disabilities: "Do not beg. Find ways of surviving on your own by striving to be self-reliant."
What Makula wishes government could do to help persons with disabilities:"Set aside a certain fraction of public service positions for persons with disabilities because competing with able-bodied people for job positions is not an easy feat. Also, it should avail them training opportunities including internship and apprenticeship programmes."

PWDs face many challenges in Uganda. However they are helped by robust local legislation based on the CRDP. This legislation helps support vulnerable CWDs and their parents whilst getting an education. The challenges CWDs face remain throughout life. Despite these comprehensive laws supporting human rights there is often a failure to implement legislation, this is most commonly caused because of lack of finances. All this aside, education is a means of reducing poverty and moreover inclusive education, mixing CWDs with non disabled counterparts, is one of the best ways of reducing stigma and prejudice.

Poverty and Disability

Poverty is a complex multidimensional issue. An Overview of Poverty in Uganda shows that poverty is a multilayered issue that requires action to be taken in many different social and economic areas. Before looking in more detail at poverty and disability in Uganda it is necessary to get an overview of disability and poverty.

The 2005 report Disability, poverty and the new development agenda notes that an estimated 10,000 disabled people die every day as a result of extreme poverty. There are many reasons for this lamentable situation. This blog has shown that people with disabilities are more likely to live in poverty (see Poverty and Disability In Uganda). Poverty is a cause of disability and likewise disability is a cause of poverty. This is the cycle of poverty. 

The poverty cycle works like this: People who live in poverty have less access to healthcare and are more vulnerable to malnutrition and preventable diseases. The Cycle of Poverty and Disability web page says persons with disabilities (PWDs):

are also more likely to live and work in dangerous or polluted environments with low quality housing, reduced access to safe drinking water and sanitation; and are more likely to live in areas which are prone to the effects of natural disasters, dangerous traffic and higher rates of violence.

Further more disability is a cause of poverty. Negative attitudes like stigma and prejudice, (see Summary of findings of the Uganda Disability Review Part 1 of 2) severely limit educational and employment opportunities. The Cycle of Poverty and Disability web page continues to describe the position of PWDs:

Stigma and shame lead to isolation from families and communities, so that they are less likely to be members of self-help groups, religious organisations or community initiatives, including development programmes.

There are many other reasons that disability is linked to poverty. Discrimination caused by prejudice against individuals with disabilities, also called ableism (see What is Ableism?) significantly impacts on PWDs. Wikipedia continues saying that further:

forms of discrimination may lead disability to be more salient in already marginalized populations. Women and individuals belonging to certain ethnic groups who have disabilities have been found to more greatly suffer from discrimination and endure negative outcomes. Some researchers attribute this to what they believe is a “double rejection” of girls and women who are disabled on the basis of their sex in tandem with their special needs. The stereotypes that accompany both of these attributes lead females with disabilities to be seen as particularly dependent upon others and serve to amplify the misconception of this population as burdensome. In a study done by Oxfam, the societal consequences of having a disability while belonging to an already marginalized population were highlighted, stating, “A disabled women suffers a multiple handicap. Her chances of marriage are very slight, and she is most likely to be condemned to a twilight existence as a non-productive adjunct to the household of her birth… it is small wonder that many disabled female babies do not survive.” Additionally, women with disabilities are particularly susceptible to abuse. A 2004 UN survey in Orissa, India, found that every women with disabilities in their sample had experienced some form of physical abuse. 

Health care is another significant factor impacting on poverty:

Another reason individuals living with disabilities are often impoverished is the high medical costs associated with their needs. One study, conducted in villages in South India, demonstrated that the annual cost of treatment and equipment needed for individuals with disabilities in the area ranged from three days of income to upwards of two years’ worth, with the average amount spent on essential services totaling three months worth of income. This figure does not take into account the unpaid work of caregivers who must provide assistance after these procedures and the opportunity costs leading to a loss of income during injury, surgery, and rehabilitation. Studies reported by medical anthropologists Benedicte Ingstad and Susan Reynolds Whyte have also shown that access to medical care is significantly impaired when one lacks mobility. They report that in addition to the direct medical costs associated with special needs, the burden of transportation falls most heavily on those with disabilities. This is especially true for the rural poor whose distance from urban environments necessitates extensive movement in order to obtain health services. Due to these barriers, both economic and physical, it is estimated that only 2 percent of individuals with disabilities have access to adequate rehabilitation services.
The inaccessibility of health care for those living in poverty has a substantial impact on the rate of disability within this population. Individuals living in poverty face higher health risks and are often unable to obtain proper treatment, leading them to be significantly more likely to acquire a disability within their lifetime. Financial barriers are not the only obstacles those living in poverty are confronted with. Research shows that matters of geographic inaccessibility, availability, and cultural limitations all provide substantial impediments to the acquisition of proper care for the populations of developing countries. Sex-specific ailments are particularly harmful for women living in poverty. The World Health Organization estimates that each year 20 million women acquire disabilities due to complications during pregnancy and childbirth that could be significantly mitigated with proper pre-natal, childbirth, and post-natal medical care. Other barriers to care are present in the lack of treatments developed to target diseases of poverty. Experts assert that the diseases most commonly affecting those in poverty attract the least research funding. This discrepancy, known as the 10/90 gap, reveals that only 10 percent of global health research focuses on conditions that account for 90 percent of the global disease burden. Without a redistribution in research capital, it is likely that many of the diseases known to cause death and disability in impoverished populations will persist.

Bringing clean water and a smile to people living with disabilities in Uganda

Insitutional barriers are further contributory factors to the poverty of PWDs. Wikipedia says:

Accessibility: Physical environment may be a large determinant in one’s ability to access ladders of success or even basic sustenance. Professor of urban planning Rob Imrie concluded that most spaces contain surmountable physical barriers that unintentionally create an “apartheid by design,” whereby individuals with disabilities are excluded from areas because of the inaccessible layout of these spaces. This "apartheid" has been seen by some, such as the United Kingdom Disabled Persons Council, as especially concerning with regard to public transportation, education and health facilities, and perhaps most relevantly places of employment. Physical barriers are also commonly found in the home, with those in poverty more likely to occupy tighter spaces inaccessible to wheelchairs. Beyond physical accessibility, other potential excluding agents include a lack of Braille, sign language and shortage of audio tape availability for those who are blind and deaf.
Education: The roots of unemployment are speculated to begin with discrimination at an early age. UNESCO reports that 98 percent of children with disabilities in developing countries are denied access to formal education. According to the World Bank, at least 40 million children with disabilities do not receive an education thus barring them from obtaining knowledge essential to gainful employment and forcing them to grow up to be financially dependent upon others. This is also reflected in a finding obtained by the World Development Report that 77 percent of persons with disabilities are illiterate. This statistic is even more jarring for women with disabilities, with the United Nations Development Program reporting that the global literacy rate for this population is a mere 1 percent.... It is important to note that the deprivation of education to individuals with special needs may not be solely an issue of discrimination, but an issue of resources. Children with disabilities often require specialized educational resources and teaching practices largely unavailable in developing countries.
Employment: Some sociologists have found a number of barriers to employment for individuals with disabilities. These may be seen in employer discrimination, architectural barriers within the workplace, pervasive negative attitudes regarding skill, and the adverse reactions of customers. According to sociologist Edward Hall, "More disabled people are unemployed, in lower status occupations, on low earnings, or out of the labour market altogether, than non-disabled people." The International Labor Organization estimates that roughly 386 million of the world's working age population have some form of disability, however, up to eighty percent of these employable individuals with disabilities are unable to find work....
Sociologists Colin Barnes and Geof Mercer demonstrated that this exclusion of persons with disabilities from the paid labor market is a primary reason why the majority of this population experiences far greater levels of poverty and are more reliant on the financial support of others. In addition to the economic gains associated with employment, researchers have shown that participation in the formal economic sector reduces discrimination of persons with disabilities. One anthropologist who chronicled the lives of persons with disabilities in Botswana noted that individuals who were able to find formal employment “will usually obtain a position in society equal to that of non-disabled citizens.” Because the formal workplace is such a social space, the exclusion of individuals with disabilities from this realm is seen by some sociologists to be a significant impediment to social inclusion and equality....

In summary there is good evidence that disability is linked to poverty principally in a the cycle where disability creates poverty and poverty creates disability. This feedback loop has severe effects on the life of a disabled person. Furthermore living in already resource poor areas PWDs often have to endure facilities that are less accessible than for non disabled counterparts. Access to Education, employment and work facilities become significant barriers. All this has major effects throughout the lifetime of PWDs.

Inclusion of Persons With Disabilities

This video examines the reasons persons with disabilities are excluded from community life because they are not able to access buildings. The poster has written:

In Uganda, people with disabilities have worked tirelessly to make public premises and institutions accessible to them. In Kampala, a city with hardly any side-walks, and narrow streets where motor-vehicle traffic competes for space with pedestrians, getting around for someone on a wheelchair, or even using crutches can be difficult. Commercial buildings and other public spaces remain inaccessible to people with disabilities. But some progress has been made through persistent advocacy.

Florence Ndagire

In this short clip Florence Ndagire speaks about how the rights of persons with disabilities (PWDs), in particular women with disabilities are not considered when policies are being made. The poster says:

Florence Ndagire is the project coordinator, Disseminating the findings of the project "My Story, My Rights" to the  wider stakeholders to influence policies in favour of PWDs. 

Overcoming disability stigma in Kenya

Only 2% of disabled students get to university in Kenya. This is the story of Mercy from Nairobi who fought hard to go to university.

"We all need to network with each other..."

This is an excerpt from an article, CHANGING ATITUDES – THE PEOPLE WITH DISABILITIES OF UGANDA:

SOMEWHERE IN UGANDA, A CHILD SITS ALONE in his backyard day after day. He is one of many disabled children in the country who do not have access to support like wheelchairs and crutches, and their environment itself poses its own obstacles. They are often denied the opportunity to go to school, and without an education they become the poorest of the poor.
According to Elijah Musenyente of Uganda’s Society of Hidden Talents (HITS), Uganda’s tradition has it that disability is a curse, bad luck or omen. The disabled are often kept in the backyard for fear of shaming the family. They are denied the right to go to school, marry and hold a job. Even if they escape their family’s confinement, it remains difficult to make a living when equipped with very little skills.
HITS works at the community level to teach the disabled as well as the able-bodied life skills and to build their confidence. It is also important to work with the community as a whole. One of the greatest challenges in improving the rights and opportunities for disabled people within society in Uganda is convincing the population at large of the potential and capacities held by the disabled.
“We raise awareness for people to understand that disabled people are also human beings, they are the same as others,” Richard Mugisha, director of People with Disabilities Uganda (PWDU), told me.
He said that a change in attitude is needed at all levels of society, perhaps most importantly at the government level, where the disabled are often not considered when economic opportunities arise.
The PWDU works throughout Uganda to change the fate of many children who, aside from growing up in a poverty stricken nation, face even greater obstacles due to their disabilities.