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The House On The Hill

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THE DISABLING WORLD [image, unknown]

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The house on the hill
Maggie Black reports on the new ideas in the field of rehabilitation for the disabled - and finds another example of the inappropriateness of imposing First World solutions on Third World problems.

Some years ago I was taken to see an about-to-be-opened home for disabled children, situated on a pleasant grassy hill not far from a small town in southern Ethiopia. The two storey building, with its electrically lit rooms, it dormitories and its well-equipped training workshops, had taken into account the latest word in design adjustments for the wheelchair-bound. The mentor of this institution was a well-intentioned Italian who ran the local sawmill, and who had invested boundless energy in raising the money, supervising construction, and generally performing all the minor miracles necessary to build a palace in the back of beyond.

The nearby town was situated in who must be one of the poorest rural areas anywhere in the developing world. Many of the people arriving on foot for the gossip and excitement of market day carried nothing more than a few shoots of some plant used in the brewing of beer, or a small, dried-leaf container of honey scraped from within the bark of a tree. The men carried home-made spears The women wore cowhide. Among the muddy lanes leading between the tumble-down houses there were a number of blind beggars, often led by a small boy, himself more or less deformed: a stump for a hand, an unseeing eye. And yet, in spite of the poverty and squalor, in spite of the circumstances which forced these boys to beg from the faranji (myself) with that strange clucking, hissing call sound, I could not bring myself to wish them removed from the bustling life of the town to the enforced isolation of the `home' on the grassy hill.

`Rehabilitation' there, would mean' high class attention from white-coated expatriate physio- and other therapists (Ethiopia at the time had two trained physiotherapists of its own to serve the entire country), and the latest imported techniques and technology for helpings:_ the handicapped. But it would also mean alienation from family and friends, and from everything that was familiar in life until the day this extraordinary privilege was bestowed: a privilege which singled a child out from among so many sufferers, and made him one of a tiny minority within a minority. It might well mean that he forfeit the chance of being accepted and cared for by his family, and of leading a life as nearly adjusted as possible to the norms of his society.

According to Dr. Jeanne Kenmore, Director of Education for Helen Keller International, handicapped people can be the victims of those who most want to help them. In the course of more than 20 years' experience, Dr. Kenmore has seen in developing countries many similarly tragic examples of projects intended to help disabled children: `When I first started in this field we used to aim for three good meals a day and nice clean sheets. Dreadful mistakes were made, and sometimes still are.' But among the professionally experienced, views have drastically altered. `You must not move a person from his or her environment, or impose another culture or set of expectations. You must not give a disabled child more than his unimpaired brothers and sisters, and thereby make him unacceptable in his own family. There are some so-called Rehabilitation Centres where no-one has stayed for less than eight years and some have stayed for 20, where ,rehabilitation' in no sense describes what is going on. Why teach a child braille in a country where there are no books in braille? Never mind the braille. Let him have the family.'

If information about simple cost-free therapies was available to families and communities, most of the problems faced by the disabled could be handled. These therapies range from exercising muscles by tickling a child who is a victim of Down's Syndrome so that near-atrophied limbs can come alive, to extending property a child passing through the crucial stage of poliomyelitis so that those terrible contorted deformities need not occur. They include providing simple technical aids, such as a pair of wooden ,'' crutches, and teaching the blind to walk with a cane. With suitable advice, they are well within the capacities of the o family to handle. They cannot achieve miracles: the blind boy would not learn braille, the deaf girl would not learn to speak. But they would be able to fetch water and fuel, help with the household and farming tasks, and lead useful lives worthy of human dignity and self-respect.

Maggie Black, a forrner New lnternationalist co-editor, is now editor of UNICEF News. The latest issue of UNICEF News, titled Exceptional Children' brings together the main facts and latest ideas on the subject of childhood disability world-wide. Copies can he obtained by writing to The Information Division, UNICEF, United Nations, New York, NY 10017, USA.

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