Pakistan is located in South Asia, bordering the Arabian Sea, between
India on the east, Iran and Afghanistan to the west and China to the
The population is approximately 165.803,560, with 24% of people
–around 38 million –living below the national poverty line and a
population growth rate of 2.09%.
The most recent census statistics on disability, from 1998, show that
there were 3,286,630 people with disabilities comprising 2.49 % of the
total population. This is probably an underestimate.
The Disabled Person (Empowerment and Rehabilitation) Ordinance of 1981
protects the employment, welfare and rehabilitation rights of disabled
people and is implemented through the ‘National Council for the
Rehabilitation of Disabled Persons’.
Most disabled children do not attend school. Overall at primary level,
50% of girls and 28% of boys are out of school.
According to the World Health Organization, health investment is low
and more than 75% of health financing is out-of-pocket. The Pakistan
Ministry of Health estimates that 80% of the population has access to
local health services in rural areas and 100% in cities but reports
significant regional differences.
Nursing is not considered a prestigious healthcare profession, which
is reflected by lower number of nurses (48,000) compared to physicians
(116,000). There are no specific statistics for rehabilitation
professionals, but combined, there are approximately 19,000
occupational therapists, physical therapists, Speech Language
Pathologists, psychologists, medical interns and dietitians. The
Pakistani physiotherapists are well educated university graduates; but
lack the hands-on skills required by trained physical and occupational
therapists. In Pakistan, there is little opportunity for professional
development and continuing education courses are almost unheard of.
In October 2005 an earthquake devastated the Kashmir region of
Pakistan. As a result, an estimated 95,000 people were killed while
another 100,000 people sustained injuries that were mostly orthopedic
and neurological in nature. It was estimated that there were up to
1500 people living with a spinal cord injury as a result of the
disaster. Most of the people injured were young adults, women, and
children who were in their homes and schools at the time of the
earthquake. Additionally, according to official figures, over 200,000
people have fled from their home, mainly in Bajaur, to Lower Dir
Mardan, Charsadda, Nowshera and Peshawar since August 2008. Civilians
in Swat fled within the district to Mingora and beyond – to Lower Dir,
Malakand and Peshawar. Since October, fighting has intensified in
Mohmand Agency, forcing people to flee, mainly to the plains around
Peshawar, including the twin cities of Islamabad and Rawalpindi. Not
only do these people not have homes but they also have injuries
secondary to the fighting. They have difficulties feeding their
families, let alone seeking rehabilitative care.
Every nation has to face the challenges of disability but these are
particularly marked among the world’s poorer nations. In recent years
many new insights have been gained on assisting children and adults
with disabilities to live fuller lives in community settings inclusive
community services are often the most effective in ensuring holistic
and accessible support that enables greater freedom of lifestyle
choices. They provide person-centered care and support services within
the individual’s home and community.
Three themes re-echo throughout modern policy statements:
People with disabilities have many needs
in common with their fellow citizens who are ‘non-disabled’ and they
are entitled to the same rights and responsibilities as anyone else.
The lives of people with disabilities are
richer if they remain connected with their families and have access to
community resources and amenities.
A key role of staff specializing in
disability work is for them to share their knowledge and expertise so
that many more people can be supported in their local communities.
These services nurture
the skills and resources available within communities and help them
cope with the demands of poverty as well as disability. They mobilize
the supports available in society and work in partnership with other
agencies to provide a better quality of life for everyone in the
family. They seek to remove the attitudinal and as well as physical
barriers many people with disabilities face in their daily lives.
Their goal is to encourage the social inclusion of people with
disabilities in education, in employment and community life.