People with disabilities in developing countries often face acute barriers than those in developed ones. Within developing countries, people living in rural and remote areas are the ones who are the most affected. One such area is that of Skardu district, in Baltistan division of Federally Administered Northern Areas (FANA) of Pakistan.

In Pakistan, as per the 1998 Census, 4 million i.e. 2.49% of the population are people with disabilities. However, in Skardu district, more than 23,000 people (11%) out of a population of 210,000 are disabled. The reasons for such a high incidence of disability are malnutrition, lack of pre-natal care, poor understanding and knowledge about various diseases leading to prenatal, natal and other congenital disabilities. Apart from medical reasons, the frequent mining and shelling across the border (Jammu and Kashmir is a disputed area between India and Pakistan and frequent firing and shelling is seen in the area) is also one of the causes leading to disability, especially among displaced populations.

Disability is considered a curse and people with disabilities are deprived of basic human rights. Children and adults with disabilities are forced to lead a segregated and deprived life in a highly inaccessible and mountainous area. In this region, one in every five households has a person affected by physical, intellectual or sensory impairment.

While, on the one hand 11% of the population is adversely affected by disabilities, on the other hand, there are no services to cater to their needs. Added to this, lack of access to information and rehabilitation facilities dramatically increases the risk of people with disabilities becoming socially excluded.

People in the community interpret disability as God ordained misery, that is, a punishment to be accepted with any questions, as fate. Women with disabilities are further excluded. They are subjected to social, cultural and economic disadvantages and are not considered for health care, education, vocational skills and employment opportunities.

Following sensitisation by Leonard Cheshire Disability team in Pakistan, a local NGO committed to work with persons with disabilities, has collected initial data on situation of persons with disabilities. Some of the findings from a survey conducted in the suburbs of Skardu main town are -

• A majority of people with disabilities were found among families which were very poor.
• One in every fifth household had a person with disability.
• Polio situation in Skardu region was more critical as compared to other parts of Pakistan. 12 out of 33 children and persons with disabilities were confirmed as serious polio cases by a team of World Health Organisation (WHO) specialists in May 2008.
• Most of the people who were affected by polio and paralysed can move with a wheelchair and some of them can be rehabilitated with assistive devices, but, unfortunately they have no access to these kind of services.
• There is not a single special education school to cater to the needs of children with disabilities in the region. Children with disabilities themselves avoid going to schools or their parents do not send them to mainstream schools out of shame and fear of exclusion.
• There is no awareness among parents on rehabilitation services.
• There is no physiotherapist, orthopedic specialist or other disability professionals in Baltistan.
• There are no NGOs or Government organisations working for people with disabilities.
• Although the community members are cooperative, they need to be sensitised and made aware of the needs of persons with disabilities. Only then, can their support be enlisted for community based rehabilitation services.

Keeping in view, the above situation of Skardu region, there is a dire need for collaboration among government and non-government organisations. Such a collaboration would help in meeting the goals of the UN Convention on the Rights of Persons with Disabilities and the National Policy on Disability in this remote mountainous region where, people with disabilities have been an invisible and forgotten population, till now.

Khadim Hussain
(A wheelchair user from Skardu)
Representing, Grace Association