Notes on disability in ethiopia january 2008

Notes on Disability in Ethiopia

Contents
1 Introduction .............................................................................................................................2

1.1 Prevalence and Forms of Disability .................................................................................2

1.2 Situation of Persons with Disabilities ............................................................................. 3

2 Legal and Policy Framework .................................................................................................. 5

3 Stakeholders ........................................................................................................................... 6

3.1.1 State Actors .............................................................................................................. 6

3.1.2 Non-State Actors...................................................................................................... 7

3.1.3 PwD Organizations .................................................................................................. 9

(January 2008)
Ghetnet Metiku Woldegiorgis
Socio-Legal Researcher
E-mail: gmgiorgis@gmail.com Page 1


1 Introduction
1.1 Prevalence and Forms of Disability
The 1994 Census in Ethiopia reported that there were nearly one million persons with disabilities in
Ethiopia constituting less than two percent of the total population. However, this report is far below
international estimates on the prevalence of disability in developing countries.1 According to the final
report submitted by the Special Rapporteur on Human Rights and Disability (1991) at least 1 out of 10
persons has a physical, mental or sensory impairment, and at least 25 percent of the total population are
adversely impacted by the presence of disabilities.2 Similarly, WHO and World Bank estimates of overall
disability prevalence in developing countries is 10% of the entire population.

Even subsequent official reports have criticized this report on grounds of narrow identification criteria,
exclusion of less accessible social groups such as the homeless and substantial underreporting by
reluctant families.3 Accordingly, the National Plan of Action for Children estimates the total number of
persons with disabilities in Ethiopia at around 4.9 million or seven percent of the total population of 70
million in 2003. Current estimates put the number of people with disabilities in Ethiopia around 4.5
million, of whom 50,000 live in Addis Ababa.4

Distribution of Disabled Population by Region: - 1994 Census

Region All Persons PWD’s Ratio
1 Tigray 3, 134, 470 90,742 2.80%
2 Amhara 13,828,909 281,291 2.03%
3 Oromiya 18,465,449 333,653 1.80%
4 South N. 10,368,449 174,941 1.69%
5 Addis Ababa 2,100,031 45,936 2.18%
6 Dire Dawa 248,549 4,226 1.70%
7 Gambella 162,271 2,581 1.59%
8 Benishangul Gumuz 460,325 7,341 1.59%
9 Afar 1,097,067 14,140 1.29%
10 Harari 130,691 2,909 2.23%
11 Somali 3,382,702 34,156 1.00%
Total 53,379,035 991,916 1.85%
In terms of forms of disability, the Developmental Social Welfare Policy identifies sight, hearing and
speaking impairments; physical disability of the limbs; and, mental health problems as the more
prevalent forms of disabilities in Ethiopia. Similarly, the WHO reported that total or partial blindness
(32%), leg or arm impairment (32%), and hearing/speech impairment (19%) are the most prevalent
1
GFDRE & UNICEF, 2001; IER, 1995;
2
UNICEF, (2002) Implementation Handbook for the Convention on the Rights of the Child, p.325
3
Ethiopia’s National Plan of Action for Children , p. 24
4
Handicap International (available at: http://www.handicap-international.org.uk/page_70.php)
(January 2008)


forms of disability in Ethiopia while mental disability is also frequent.5 These forms of disability are
likewise prevalent among children with disability (CwDs), who constitute more than half of PwDs in
Ethiopia.6

Types of Disability in Ethiopia – 1994 Census

Types of disability % of population
Hearing & Speech defect 5.9
Intellectual 6.5
Hand/Arm problems 8.8
Total blindness 11.9
Hearing impairments 13.3
Partial blindness 20.4
Leg problems 23.3
Overlapping 3.2
Leprosy 3.5
Other 3.2

1.2 Situation of Persons with Disabilities
In 2003, there were 26 orthopedic technicians and 80 physiotherapists in the country, which is
considerably low considering the prevalence of impairment of the limbs among PwDs.7

Though the government is currently establishing facilities for the manufacture of assistive
appliances in different parts of the country, there is an acute lack of early detection screening as
well as rehabilitation facilities for PwDs.

Due to physical and social barriers preventing their integration and effective participation in the
community, PwDs have limited access to existing health services.

Infanticide of children with disabilities by parents is practiced in parts of Ethiopia owing to fear
of the difficulty of raising the child and discrimination.

The total number of children with disabilities enrolled in schools is extremely low. Education Sector
Development Programme III estimates the total number of school age children with special needs
between 1.7 million to 3.4 million.8

5
WHO, Disability in Ethiopia: The Scope of the Problem (available at:
http://www.who.int/countries/eth/areas/violence/about/en/index1.html)
6
Ethiopia’s National Plan of Action for Children, 2004, p. 24
7
National Programme of Action for Persons with Disability
8
Ministry of Education, Education Sector Development Programme III, p.26
(January 2008)


An estimated less than 1% of children and students with special needs get access to primary
education9 and very few of them continue in vocational, secondary and higher education.

The special schools for children with disabilities are overcrowded and suffer from lack of special
instructional materials and facilities and shortage of staff specialized in special needs education.

The few existing special schools, inclusive schools have also been faced with financial
constraints.10

The delivery of early childhood development programs does not reach the majority of children
with disabilities and appears to be left to NGOs many of which are inadequately resourced.11

The National Programme of Action for the Rehabilitation of Persons with Disabilities states that
efforts by both governmental and non-governmental bodies to offer vocational training to
persons with disabilities are inadequate compared to the number of persons in need.12 The
training institutions established by non-governmental institutions are few in number and ridden
with resource shortage.

The vocational training institutions currently operational are not accessible to PwDs due
problems of design and willingness to enroll PwDs.

The majority of children with disabilities are hidden at their homes or begging on the streets and
near churches and mosques.13

Persons with hearing impairment and other persons with disabilities do not have access to
information on vital matters such as the HIV/AIDS epidemic and reproductive health.14

The exploitation of PwDs, especially children with disabilities, for begging by unscrupulous
individuals is widespread. Handlers sometimes maimed or blinded children to raise their
earnings from begging.15

CwDs, especially girls with limited mobility or visual impairment, are among the groups most
exposed to sexual violence.16

9
MoE, Special Needs Education Strategy, 2006
10
Professor Tirussew Teferra, (2005), Disability in Ethiopia: Issues, Insights and Implications, p.86
11
Ethiopia’s National Plan of Action for Children, p.25
12
MoLSA, Plan of Action for the Rehabilitation of Persons with Disabilities, 1999
13
Ibid.
14
Information obtained from Ethiopian National Association of the Deaf.
15
US Department Report on Human Rights Practices in Ethiopia 2005.
16
MoLSA, National Plan of Action on Sexual Abuse and Exploitation of Children, December 2005, p 7
(January 2008)


2 Legal and Policy Framework
Article 25 of the FDRE Constitution provides that all persons are equal before the law and entitled
without discrimination to the equal protection of the law. Discrimination on the basis of disability is not
explicitly mentioned, though the phrase ‘other status’ includes disability. Article 41 of the Constitution
provides that the State shall, within available means, allocate resources to provide rehabilitation and
assistance to persons with physical and mental disabilities.

Though there is no separate policy on PwDs, disability issues have been extensively covered under the
Developmental Social Welfare Policy adopted in November 1996. The specific priority areas identified in
the Policy include the following:

Ensuring conducive environment for the effective participation of persons with disabilities

Provision of education, skill training and gainful employment opportunities to persons with
disabilities

Provision of medical/health services and supportive appliances

The creation of mechanisms by which support services will be provided for persons with
disabilities in the context of their family and community environment

The establishment of special centers where persons with disabilities will be cared for

Awareness raising to the public concerning the determinants and consequences of disability
and combating discriminatory attitudes

Designing and implementing strategies and programs to prevent the prevalence of disability
and mitigate its effects

Ensuring barrier-free physical access to persons with disabilities in residential areas, work, and
other public places

Provision of support and assistance to community action groups, non-governmental
organizations as well as voluntary associations engaged in the provision of services to persons
with disabilities.

In 1999, the Ministry of Labour and Social Affairs designed a National Program of Action for the
Rehabilitation of Persons with Disabilities that aims to operationalize the UN Standards Rules on
Equalization of Opportunities for Persons with Disabilities and the Developmental Social Welfare
Policy of Ethiopia. The major objectives of the Program are:

Taking disability prevention measures by promoting community participation

Enabling persons with disabilities to achieve a better standard of living by building their capacity

(January 2008)


Ensuring the equal rights of persons with disability and their full participation in society

The areas of focus identified in the program are prevention of disability, medical rehabilitation,
educational rehabilitation, vocational rehabilitation and employment services, accessibility, awareness-
raising, strengthening and expanding organizations’ of persons with disabilities, religion, culture, sport,
recreation and family life. However, the Program does not provide for a timetable for the
implementation of these activities making it difficult to monitor progress. Thus, the implementation of
the Developmental Social Welfare Policy and the National Program of Action for the Rehabilitation of
Persons with Disabilities remains a challenge.

The National Programme of Action for Children for the period 2003 – 2010 and beyond, which was
issued in June 2004, has also set up a national consultative mechanism involving sector ministries and
the Federation of Persons with Disabilities to coordinate and oversee the implementation of Community
Based Rehabilitation (CBR) programs targeting CwDs. Moreover, due to their primary mandates in
relevant sectors, various ministries and their regional counterparts are among the key state actors in
the realization of PwD’s rights. These include the Ministry of Health, the Ministry of Education, the
Ministry of Women’s Affairs, and the Ministry of Information.

In December 2005, the Ministry of Labor and Social Affairs issued a National Plan of Action on Sexual
Abuse and Exploitation of Children (2006 - 2010) with the aim of improving the protection of children
from sexual abuse and exploitation and access to legal, psychosocial and medical information and
services. At the outset, the Plan of Action has identified CwDs among the groups most vulnerable to
violence, including sexual violence. To this end, the document has identified four areas of
intervention: prevention, protection, rehabilitation and reintegration, and coordination and
monitoring.

3 Stakeholders
3.1.1 State Actors
The Department for Rehabilitation Affairs within the Ministry of Labour and Social Affairs is the body
responsible for coordination of disability issues at the federal level. The Department is charged with the
duty to

“Study and in cooperation with other organs, ensure the implementation of ways and
means of providing assistance to the aged and persons with disabilities as well as the
rehabilitation of persons with disabilities”.17

This mandate extends to: designing policy, strategies to deal with the PwD’s issues at a national level;
and implementing specific programs such as capacity building training, establishment of institutions for
production of prosthetic devices, dissemination of information, and strengthening DPOs and other
organizations working on disability issues at the federal level.

17
Proclamation to define the Powers and Duties of the Executive Branches of the FDRE (Proclamation
4/1995), Article 20 (10)
(January 2008)


At regional level, Bureaus of Labor and Social Affairs are responsible for implementation of the policy
and national programme of action. The Bureaus also coordinate interventions by both state and non-
state actors to address disability issues and realize the rights of PwDs. In Addis Ababa, the task is
undertaken by the Social and Civil Affairs Bureau.

In 2002, a national forum of organizations working in the field of disability was formed as a MoLSA
initiative to create space for non-state actors, coordinate disability related interventions and share
experiences. Though not directly focused on disability, the multi-sectoral Networking of Organisations
Working in Support of Orphans and Vulnerable Children (OVC Network) are also important in the
coordination of interventions on disability issues. Moreover, there are a number of other institutional
frameworks established to coordinate initiatives directly related to violence against PwDs, especially
women and children, in Ethiopia. These include the CRC implementation structure (child rights
administration), high level taskforces on child labor, orphans and vulnerable children and trafficking in
persons, the National Steering Committee on Sexual Abuse and Exploitation of Children, and the
National Steering Committee on Justice Reform.

In 2006, the Ministry of Justice has established a Center specializing in Prevention, Prosecution and
Legal Support in cases of violence against women and children in Addis Ababa in collaboration with
UNICEF.18 The Center undertakes prevention, counseling,19 investigation and prosecution of VAWC
through coordination among Courts, police and prosecution towards a more speedy investigation and
prosecution as well as increases in conviction rates. The success of the VAWC Center in Addis Ababa has
prompted similar initiatives at the regional level. A case in point is the establishment of a specialized
prosecution office for crimes against women and children in the Amhara Region. Moreover, with a view
to addressing the significant gap in legal aid service provision, law faculties of government universities
have established legal clinics using academic staff and students to provide free legal services as part of
the education process. Currently, at least three government universities at Mekelle, Bahir Dar and
Awassa have established legal aid centers.

3.1.2 Non-State Actors
A large number of non-state actors representing a broad profile of organizations are working to
improve the situation of the rights of PwDs in Ethiopia at various levels in collaboration with the
government and government agencies. These include UN agencies, Inter-Governmental Organizations,
international NGOs, indigenous NGOs, community-based organizations (CBOs), faith-based
organizations (FBOs) women’s associations, children's organizations and youth associations. While the
mandates of most of these institutional actors may be defined in terms of sectors or vulnerable groups
they focus on, many address the problems, issues and rights of PwDs.

These organizations use different approaches including awareness raising, conducting researches and
surveys, advocacy and lobbying, and community based development initiatives. Important areas of
engagement for non-state actors are:

18
The Centre has been established in the Lideta branch of the FFIC. The Ministry of Justice is also in the
process of establishing a similar office in Dire Dawa.
19
The VAWC Prevention, Prosecution and Legal Support Center has not yet comprehensively included the
provision of psychosocial and medical services as well as rehabilitation and reintegration of victims.
(January 2008)


awareness raising and advocacy initiatives that aim at change of laws and practices at the formal
and non-formal level;

capacity building support to judicial, law enforcement and other structures involved in
prevention and protection; and

providing support to vulnerable groups as well as victims of violence.

A number of national NGOs operate shelters for vulnerable groups and victims of violence. These
include:

The FSCE drop-in center that provides counseling and rehabilitation services to children who
are victims of prostitution in Addis Ababa;

The African Network on Prevention and Protection of Child Abuse and Neglect (ANPPCAN)
supports community-based Child Abuse Reporting Centre in Woldia (North Shewa Zone,
Amhara).

Integrated Family Support Organization (IFSO) provides counseling for victims of rape, while
the Tsotawi Ttekat Tekelakay Mahiber (TTTM) provides shelter and accommodations in Addis
Ababa, and

The Organization for the Prevention, Rehabilitation and Integration of Female Street Children
(OPRIFS) provides safe home for girls in Addis Ababa.

Legal aid services are also provided by NGOs. These include:

Legal advice, counseling and representation provided by the Ethiopian Women Lawyers
Association (EWLA) to victims of GBV/VAWC in criminal and civil cases in Addis Ababa,
Nazareth, Dire Dawa, Awassa, Gambella, Assosa, and Bahir Dar.

Legal services provided by the Action of Professionals Association for the People through ten
legal and human rights resource centers, three joint projects with regional legal
professionals’ associations and two legal aid centers in Addis Ababa, Bahir Dar, Awassa, Dire
Dawa, Jimma, Harar, Adama, Assela, and Debre Berhan.

Free (pro bono) legal services provided by the Ethiopian Bar Association in the premises of
the Federal High Court in Addis Ababa.

ANPPCAN – Ethiopia has established a helpline for children called Reporting Center for Child Abuse in
Addis Abada. The Child Helpline operates 10 hours a day and provides medical, counseling, legal and
family reunification services for victims of child abuse. EWLA has completed preparations to
commence an additional hotline service for victims of gender based violence in 2008.

(January 2008)


3.1.3 PwD Organizations
A category of CSOs/NGOs that may be considered separately are associations established by PwDs and
organizations directly working on disability issues (DPOs). Most of the DPOs are members of the
Ethiopian Federation of Persons with Disabilities. The Federation is an umbrella organization of five
single disability focused national associations. These are:

The Ethiopian National Association of the Blind,

The Ethiopian National Association of the Deaf,

The Ethiopian National Association of Ex-Leprosy Patients,

The Ethiopian National Association of Mentally, Retarded Children and Youth.

The Federation and member associations are engaged in advocating for cessation of social
discrimination and promoting the rights of PwDs. Their activities include advocacy and awareness
raising, initiating research and information gathering activities, offering capacity building as well as
economic empowerment and integration of persons with disabilities.

Other organizations focusing directly on disability issues include the Ethiopian National Association of
the Physically Handicapped (ENAPH), Handicap International, Rehabilitation and Preventive Initiative
Against Disability (RAPID), SALU Self-Help Blind and Handicap Association, Addis Ababa Sport
Federation of the Disabled and Cheshire Services Ethiopia. These organizations are among those actively
engaged in the implementation of comprehensive community based rehabilitation (CBR) activities.

Handicap National has been engaged in the implementation of comprehensive community based
rehabilitation (CCBR) activities since its establishment in 1998. One of the components of the
Comprehensive Community Based Rehabilitation as implemented by Handicap National is advocacy
with focus on creation of positive attitudes towards children with disabilities. Accordingly, Handicap
National has organized a variety of workshops, exhibitions, radio programs and coffee ceremonies
aimed at raising awareness to prevent disability and its progression. The other component is the
provision of medical rehabilitation services to children with disabilities in cooperation with other
stakeholders. In this regard, Handicap National has been providing physical appliances for those
children with physical disabilities and facilitates opportunities for referral services. For this purpose,
fieldworkers are assigned to provide home-based therapeutic services for children with disabilities.
This rehabilitation component is also coupled with psychosocial support for children with disabilities
and their parents.
Cheshire Services has been implementing comprehensive community based rehabilitation programs.
Cheshire has been providing children with post paralysis physical rehabilitation in cases where
surgical intervention, plaster of Paris and physiotherapy treatments are required for the
rehabilitation of victims of polio aged 7-15 years. Cheshire Services is also engaged in the production
of orthotic materials to enhance mobility of children and youth with disability including tricycles.
Mobile rehabilitation team of Cheshire service Ethiopia provides essential follow up care for disabled
children and young people in their own localities and looks after more than 6500 patients annually,

(January 2008)


providing them with walking aids such as crutches, braces, orthopedic shoes and walking frames
twice a year( in most cases). Through this program 36 outreach locations are being covered in 9
regions and administrative councils. Other components of the CBR being implemented by Cheshire
Services include exercise therapy, awareness raising, economic empowering and offering trainings
for rehabilitation workers, CBR planners and managers.
Save the Children organizations have been actively engaged in awareness raising activities in their
target areas. The International Save the Children Alliance has been sensitizing on early childhood
development on Radio Fana which is vital in the prevention of disability. However, the exorbitant
fees state media outlets charge has been a stumbling block to the continuity of advocacy work.
Therefore, this would require media outlets to give free airtime to programmes meant for awareness
creation. Save the Children Norway has been undertaking such activities in Chilga and Lay Armachio
and other parts of the country. Save the Children UK has also been doing same in Legambo,
Mekedella and Debresina weredas of South Wollo as well as weredas 7 and 12 of Addis Ababa.

Organization Objectives Activities
Ethiopian National protecting the human rights of the deaf in registration of the deaf,
Association of the Deaf getting equal access to medical care, organizing sporting and
(ENAD) education, employment, social and cultural recreational activities, providing
life of the society in collaboration with other interpretation services in schools,
stakeholders hospitals and courts,
awareness raising concerning
HIV/AIDS in Addis Ababa,
preparation of sign language and
providing audiology test at low
cost.
Ethiopian National provide education and assist persons with runs elementary boarding
Association of the Blind visual disability in furthering their schools,
(ENAB) integration into Ethiopian society; organizes training activities and
raise awareness on the situation of people community-based rehabilitations
with visual impairment, and programs for blind persons and
promote employment opportunities for promotes self-employment
visually impaired persons. activities
Ethiopian National attitudinal changes towards persons with provides basic education courses
Association of the physical disability by running awareness- and vocational rehabilitation in
Physically Handicapped raising campaigns and advocacy activities the areas of tailoring, agriculture,
(ENAPH) leather work and carpentry
community-based rehabilitation
program focused on
psychological rehabilitation of
persons with physical disabilities
provides them training and
employment opportunities.

(January 2008)


Ethiopian National protection of children with mental awareness raising in combating
Association for Mentally retardation form from exploitation and discrimination against children
Retarded Children and abuse, and with disabilities,
Youth soliciting support for poor parents of provision of vocational and life
children with mental retardation skill training for children with
mental retardation, and
parenting education
Ethiopian National advocating for equalization of opportunities and full participation of persons
Association for Ex- affected by leprosy,
Leprosy Patients awareness raising and bringing about attitudinal changes among the society about
(ENAELP) leprosy and persons affected by leprosy,
addressing the cultural, social and economical problems of persons affected by
leprosy, and
networking and collaborating with government and non-governmental organizations
to promote studies pertaining to leprosy

(January 2008)

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