Training for rehabilitation

Interview with Major H.P.S. Ahluwalia.

Until recently, the level of public commitment to the rehabilitation of the disabled, or the physically challenged, was minimal and the field was dominated by a number of institutions running a variety of training programmes based on different models without any uniform standard. If there is a sea-change in the situation today, it is largely owing to the sustained work of the Rehabilitation Council of India (RCI), which in June 2003 will complete, as a statutory body, a decade of service to disabled persons. In an interview in New Delhi to B.S. Padmanabhan, the Chairman of the RCI, Major H.P.S. Ahluwalia traces the context in which the RCI was set up and the steps taken by it to regulate and standardise the training programmes to empower the disabled in order to let them enjoy their fundamental rights and join the mainstream of national life. The genial Major, who as a member of the first successful Indian team to climb Mount Everest hoisted the national flag atop the peak but subsequently became a victim of disability following a spinal injury, has over the past decade and more provided testimony to the fact that sheer personal grit and determination can help individuals overcome the challenges posed by disability (see feature written by him on the 1994 Central Asia Cultural Expedition along the Silk Route that he undertook along with other team members, in Frontline, September 9, 1994). Excerpts from the interview:

Can you provide an idea of the magnitude of the problem of disability in India?

There are an estimated 600 million persons with one form of disability or the other all over the world, and 10 per cent of this number is estimated to be in India. That means we have around 60 million and this figure is increasing because the car culture, modern life and the way people move about are all adding to disabilities. A more precise estimate of the incidence of disability will come out of a survey which the National Sample Survey Organisation will conduct this year. But my own estimate is that it will be around 40 million. Even this is a large number.

What was the context in which the Rehabilitation Council of India was set up?

As you know, there was "Education for All" - but not for persons with disabilities. There was "Employment for All" - but not for persons with disabilities. There was no accessibility at all for persons with disability. The disabled could not move around due to lack of facilities such as ramps. That was why this segment of the population was remaining away from the mainstream. They could not access fully libraries or educational institutions.

What then happened was that there was a sort of free-for-all and people developed their own courses. Somebody started a six-month course, somebody started a one-year diploma course, somebody started a course in speech pathology, and so on. There was no control. So the government decided that all these should be regularised and regulated. For this purpose, the government enacted the Rehabilitation Council of India Act, 1992. Prior to this, the Rehabilitation Council of India was formed as a registered society in 1986 but the need was felt for a statutory body in order for it to be more effective.

The RCI as a statutory body came into being in 1993. Then came two other important pieces of legislation. One was the Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act of 1995 and the other was the National Trust for Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities Act of 1999. All these broadly brought the situation under control.

What is the mandate of the RCI?

The main objectives of the RCI are to regulate training programmes in the field of rehabilitation of persons with disabilities, to bring about standardisation in the education and training of various categories of professionals dealing with persons with disabilities, to accord recognition to institutions running the courses and withdraw recognition wherever facilities are not satisfactory, to recognise foreign degrees, diplomas and certificates on a reciprocal basis and to develop post-graduate courses.

That means the RCI has been set up on the lines of professional bodies such as the Bar Council of India, the Medical Council of India and the Dental Council of India...

Yes, but we are looking ahead of them. For instance, the government's policy is to promote "inclusive education". There are 10 million children with disabilities and you cannot have special schools for all of them. There are good schools in all the villages. The government has come out with the policy of compulsory education for all children, including those with disabilities. The government has done its job but the disabled children will not all go to school, for two reasons. If the parent is not sensitised and is not made aware of the advantages, he will not send the child to school. Secondly, if the teacher is not sensitised and is not going to look at the student with disability with understanding, what is the idea in sending the child to school?

The RCI looked at these two components and came to the conclusion that unless these are remedied, compulsory education of disabled children will not come about. For the first time the RCI developed a foundation course for elementary school teachers and it was brought into effect about three months ago. As the elementary school teachers cannot take time off to attend the course in an institution, we have introduced it in the distance education mode through the Bhoj University in Madhya Pradesh. The course provides for a three-week face-to-face interaction. This has been very well received and most of the schools are availing of this. The North Eastern Council has made this course compulsory for all elementary school teachers in the northeast and has undertaken to reimburse the fees. This is a big movement because there are 60 to 70 lakh schools that we need to focus on. We have set up 200 study centres to which teachers in and around that area are linked up. This is becoming very popular.

So far as sensitising the parents is concerned, the Indira Gandhi National Open University (IGNOU) is going to launch shortly a programme through the distance education mode and this project will be covered under the Sarva Siksha Abhiyan. Now we have to find a way to make the child with disability to go to school.

Another thing is that today bright children among the disabled cannot go beyond Class 10. Particularly the girl child will require security and financial support to go up. So we are interacting with a number of universities and persuading them to open departments of rehabilitation sciences so that these children with disabilities, along with normal children, can have higher education. In this context, the Ministry of Social Justice and Empowerment is opening the College of Rehabilitation Sciences in Gwalior. This will cater to higher studies, that is, at the post-graduate, doctoral and research levels, in most of the 16 categories of rehabilitation professionals.

It was reported that Pittsburgh University had been approached for assistance for this project. What will be the nature of assistance?

In the matter of the College of Rehabilitation Services, Pittsburgh University will collaborate in some of the areas of study. The RCI will develop the courses, which will be offered by the college.

All these cover the educational needs of persons with disability. What are your plans regarding their medical rehabilitation?

At the grassroots level where the disability occurs the first port of call is the Primary Health Centre (PHC), The doctors and nurses in the PHCs do not have adequate knowledge of disabilities and they treat the disabled as any other patient. This adds to the population of the disabled. So the RCI has developed a three-day course for doctors manning PHCs to create an awareness and impart knowledge as to what is required of them to reduce disability, if a patient approaches them. We have identified 30,000 PHC doctors all over India and so far we have been able to train 12,000 to 13,000 doctors. The RCI has a number of other projects. We have set up seven zonal advisory committees to give an opportunity to regional institutions to share some of the activities of the RCI. In a sense this implies decentralisation and should help in creating greater awareness in rural and remote areas. They will develop and run courses on our behalf. The zonal advisory committees have sub-committees for health, education and media, which periodically meet and initiate measures for creating awareness about the rights of the disabled and about the programmers they can avail of.

Prior to the setting up of the RCI, a number of non-governmental organisations were in the field. What is their role now?

The RCI organises courses through NGOs and institutions. We already have 160 institutions registered with us and a majority of them are NGOs. Eighty per cent of the NGOs are conducting the foundation course, and in future their services will be utilised for parent training and other short-term programmes. They are on our panel and are running different courses. Every two years we monitor them.

What about the professionals who have been taking care of the disabled before RCI came into being?

We have upgraded their knowledge and skills through a bridge course. This was done as a special case for those personnel who were working in the field prior to the implementation of the Act. We have covered 12,000 professionals working in various institutions and have registered them with the Council.

It was reported that there was resistance from them to your bridge course.

Initially there was resistance but it is no longer there. They were following different models. All of them have now been covered through the bridge course and brought on a par with others.

What is the direction in which you would like to move in future?

Because of the problem of the large numbers to be trained, the RCI is moving towards the latest tools of Information Technology, the use of which is being worked out. We plan to link up all the study centres through satellite so that there is a tele-rehabilitation system, whereby a course can be run through a control centre and beamed to all the study centres. We have initiated the work of installing dish antennae and so on. We propose to start with 25 centres and gradually expand to cover all the study centres. Such a thing has not been done anywhere before. Then we have a programme of sensitising the State governments, policy-makers, mediapersons and so on. All these will bring about the desired change in the mindset of the policy-makers and the general public to appreciate the rehabilitation needs of those with disabilities.