Disability in Afghanistan

Shakila, aged 5, was born with a short leg
Shakila, aged 5, was born with a short leg (© Kanishka Afshari/FCO/DFID)

Afghanistan is one of the countries with the world’s highest percentages of disabled people. It’s estimated that over 800,000 people have some kind of disability, that’s over 1 in 20 Afghans. Many have been permanently injured as a result of the past two decades of war. Even now, 200 to 300 people are taken to hospital every month with landmine injuries – how many die in the minefields or on their way to clinics is a mystery. Because of the ongoing war and extreme poverty, every year thousands of Afghan children die of preventable diseases or are maimed for life.

Producers: Eric Beauchemin & Hélène Michaud

Original broadcast: November 28, 2000


On 3rd December, we will have this bicycle race in Afghanistan. The 3rd of December is the day for the disabled, for the Disabled people. It’s the international day of disabled people. So disabled people or disabled children of Afghanistan should do something to their solidarity with disabled people of the world.

Welcome to this special edition of A Good Life, coming to you from Radio Netherlands. I’m Hélène Michaud. Afghanistan is one of the countries with the world’s highest percentages of disabled people. It’s estimated that over 800,000 people have some kind of disability, that’s over 1 in 20 Afghans. Many have been permanently injured as a result of the past two decades of war. Even now, 200 to 300 people are taken to hospital every month with landmine injuries – how many die in the minefields or on their way to clinics is a mystery. Because of the ongoing war and extreme poverty, every year thousands of Afghan children die of preventable diseases or are maimed for life. On the eve of the International Day of the Disabled on December 3rd, Eric Beauchemin reports from the eastern city of Jalalabad in Afghanistan.


EB: We’re in a field right near one of the main hospitals here in Jalalabad. And there are a group of children. Let me see there are 3, 6, children riding around on bicycles. There’s another group of around 14 children who are sitting down. A lot of them have crutches. What’s actually going on here? We have a rehabilitation programme for the disabled children here. In the rehabilitation programme we have cycle riding. So here they are in a field to learn how to ride bicycles. At the end of each month they are receiving bicycles to use it for going to school, how they are going to bazaar and buying groceries for their families. And if you ask them, there would be many orphans among these children and they are responsible for their families. And when this session is finished, they are going to the classroom where they are learning how to read and write and how to calculate things. So this is a beginning for them to be rehabilitated, I mean to improve their mobility, to improve their education with the hope that when they are leaving the centre, they will be able to go to school and continue their education.

Dr. Abdul Baseer is the director of the Afghan Amputee Bicyclists for Rehabilitation and Recreation. AABRAR was set up in 1992 in Jalalabad, located in a green, hot valley, about an hour’s drive from the border with Pakistan. Over the past eight years, AABRAR has trained over 2000 disabled people to ride bikes. 11-year-old Imra is one of the latest to arrive at the AABRAR centre. As a child, he got polio. Even with a crutch in his right-hand, he has trouble moving around.

There was a man, he told me about this programme, and when I talked to my parents, they send me here to go and there will be a change in your life, and you can continue your education when you get this kind of training and you will be mobile. EB: You’ve been here for 15 days here. Can you ride a bike now? Yes. EB: Did you find it difficult to learn how to ride a bike? Yes. He said that at the beginning, the most difficult task was how to keep his balance on a bicycle. And his trainer and his other disabled friend helped him how to keep his balance in the right position. And now he’s too much improved. And even now he says that sometimes he can fall from a bicycle. EB: Do you like riding a bike? Yes. EB: What do you like about riding a bike? He like to compete. EB: When you go back home, you’re going to take a bike with you? Yes. EB: How do you think your life will change with a bike? He will use it to go to school. EB: Before this, how did you go to school? So he says that he could hardly go to school before because it used to take one hour. And when I asked how much it will take when he go by bicycle, he said 10 minutes. He will use his bicycle for transportation to his school and back and to bazaar and he says he will go to entertainment place whenever he likes. And when he tired, he will park it at home and also he will bring groceries for his mother.

EB: Do these children have any trouble learning how to bike? Of course, because when they first started, most of them had got contractures, specially contracture of the knees and the hip. EB: Contracture is when their knees or their legs stiffens up. Yeah, yeah and cannot extend it fully or cannot flex it fully, so that’s called contracture. Usually the polio victims are developing contracture, and also the mine victims, when there is no proper care, physical therapy care, so they need to develop a contracture. So our bicycle trainer and the physical therapist and a doctor, they are all working together. If there is anything like contracture, it can be corrected. At the same time, when they are riding bicycles, they are receiving the physio-therapy treatment. EB: How long does it take to get these children to actually start learning to use the bike? They could learn in three weeks. But we just have one extra week, and we have a hostel facility here. We are providing food and we are providing everything for them, and they are staying here for 24 hours. EB: And when they finish, you send them home with a bike. With the bike, and we don’t charge anything. Everything is free of cost, and we providing literacy books for them to continue their education when they are homes, and also a bicycle if they want to go to home. EB: How many children have you taught how to bike so far? This year we graduated 120, and we will graduate the whole year 240 children. EB: What type of a change does it make in these children’s lives afterwards? They’re completely changed because now they are isolated. Just lying at their homes, but when they are mobile and can go to the entertainment places, they can go to their schools. They can go to the bazaar and they can enjoy. You know, cycling is something enjoyable. But especially the disabled people who are unable even to walk in one time, they found themselves that they are riding bicycle, and they are faster, mobile. So they are enjoying it.

The Afghan Amputee Bicyclists for Rehabilitation and Recreation not only provides the children with basic literacy and math classes while they’re in the centre, they also teach them some skills such as making paper flowers to sell. 13-year-old Habiballah only arrived a few days ago and he’s still trying to get the hang of making paper flowers. He too got polio as a child. His left leg is completely paralysed and he has very little strength in his right leg. Before coming to the AABRAR centre, he was going to school, but it wasn’t easy for him.

Habiballah (© Eric Beauchemin)

He says that while he was walking to school, several time he has to sit for 10 15 minutes in order to take a rest and again he was starting to walk again again, and so he said 5 or 6 times he was just sitting on the way up to school. EB: How long did it take you to get to school before? 2 hours. Usually he wake up at 6 o’clock and starting his trip to school. And he said he used to get to school at 8 o’clock in the morning. EB: And for a child without any disability, how long would it take him or her to go to school? He says that a normal boy can get to school in one hour but for him it used to take 2 hours. EB: Have you started to ride a bike yet? Now he can keep his balance and he can ride just a little bit, but not fully. He’s confident in his trainer. He says that he will learn him how to ride bicycle as soon as possible. EB: Did you fall a lot the first few days? The first day he was falling, he says if you see his leg, he got a kind of little bruises. But now he’s not falling. EB: Did you get discouraged the first few days? No, he was very happy because he wanted to learn his bicycle. EB: How is your life going to change when you start riding your bike, Habib? It will bring a lot of changes, especially the time which I used to go to school, it used to take 2 hours. Now it will take 20 to 30 minutes. EB: You say that it’s only going to take you now 20 or 30 minutes to go to school. Does that mean you’re going to be sleeping in the morning and does that mean that you have to get up and still help your mom or your dad with their work? He will get early as before and he will just do prayers and later on if there was anything at home to be done, he will help his mother, I hope so.

EB: Baseer, this is a very original idea to use bicycles to help disabled people or disabled children. How did you come up with the idea? When I was in Peshawar, I used to work in a hospital where many, many war victims, mine victims and different type of people, they were coming to hospital and usually they had amputation and things like that. And on my way from the hospital to home and from home to hospital, I noticed a person with an amputated limb which was above knee, and this gentleman was from Pakistan and he lost his leg in a car accident. We got acquaintance to each other. And then I was thinking what about those Afghans, they’re 8 lakhs right now according to the UN estimation EB: 800,000 disabled. 800,000 disabled in Afghanistan. If everybody is finding a job and cannot go to it. Then this idea of bicycles came to my mind. Why not just have a kind of programme. Then I found two disabled Afghans in the hospital. I started this practice how to ride on bicycles. And I was successful in that. Because they learn within three weeks they could ride. And also I started studying the journals regarding disabilities and specially cycles and these things. So far, 2000 people already graduated, mine victims and polio victims from our programme. 8 bicycle races conducted. We haven’t got any injury, any serious injury. Those small injuries, this is even normal with the normal people if somebody’s learning bicycle. He should fall and he can have bruises or things like that. But serious injury at eight bicycle races where 150 and 130 and 100 people were participated, thanks god, nobody hurted, nobody fall seriously, so, I think it’s a good achievement.

In the afternoon, the kids go out to another small field outside the AABRAR centre and play football. Most of them are good players, despite their crutches. All these activities, but particularly the cycling, says Dr. Basir, help strengthen their muscles.

Yeah of course. Believe me when I see our graduates from last year and the year before last year, when they are coming to our centre, I myself cannot believe that he was a polio victim before. I’m telling them that you told lie to me that you are a polio victim. Most of them their muscles are very good now and they got very good strength because even the very wasted muscles, if the leg which has good muscles, if you use that leg it can also use the affected leg because when he’s pulling the pedal, the other leg will also be turning around. So it also affecting that. But there is one type of disabled which we call it polio grade 3. In most cases, although we are trying with them because at the early age, there’s a chance that their muscle can be revitalised, we are trying with them, but sometimes they’re hopeless. EB: What type of impact does it have on them psychologically to be able to mobile for the first time in their lives, to be able to do things independently? You know this has a great psychological impact because the things they wanted to do it, they cannot do it easily. But if somebody is mobile, I think they will not feel shame for it. Because he will feel very strong that if you can do something, that’s I can do something.

Afghan families have tended to hide their handicapped relatives. They were regarded as a source of shame. But society is having to re-evaluate its attitudes towards disability, if only because so many people have lost limbs or become handicapped. To raise awareness, charities are trying to involve ordinary Afghans in the care of the disabled, says Peter Coleridge of the Comprehensive Disabled Afghan Programme. His group is using a concept developed in the 1970s by the United Nations, called community-based rehabilitation or CBR.

Western models of rehabilitation as they were then, were far too expensive for the Third World or developing countries. And CBR is based on training community members in very basic skills to rehabilitate disabled people. Their task is to identify disabled people, decide what kind of help the community and the programme can offer and then to arrange the necessary services. So our services range from orthopaedic workshops, physiotherapy, job placement, micro-credit, job training, and integrating disabled children in schools. EB: How effective is the community-based rehabilitation approach? In the context of Afghanistan, it’s the only approach that can work. There aren’t any institutions for disabled people, thankfully because in many countries where they exist, they tend to be very ineffective and not very humane. So within the context of Afghanistan, the community based approach is really the only thing which is appropriate. And by involving members of the community, you are also changing attitudes about disability and disabled people among community members, and that’s half the battle. Disability is a rights issue. It’s about attitudes and exclusion and discrimination and so forth, and you can only start to tackle these things if you deal with people’s attitudes. So by involving them in the community, you are already beginning to change attitudes.

SERVE (© Eric Beauchemin)

SERVE is a Dutch organisation which is also trying to raise awareness about disability in Afghanistan. SERVE runs a school for deaf children and the director, Su Chu Lee, showed me around. We started in the kindergarten class, where six children were beginning their second week of school.

It has been difficult trying to advertise on the radio and asking parents to send their children. I think it’s because of transport problems or the fact that they do not think that deaf children could learn anything. So this is a small class at the moment, and we believe more will be coming soon. The aim of this class for one year will be to help them to generate and develop sign language which is their natural language. So we can see a teacher showing them visual pictures or shapes of fruits like for example a banana or an apple, and then also to show them the sign, and then the children will imitate and slowly they will develop their own language.

Deaf boy
Deaf boy (© Eric Beauchemin)

My brother encouraged me to go to school. He himself is deaf, his brother. Then he came to school and he learned in KG class and after KG class and Grade 1. One week ago, the school started their lesson again and now are happy to come to school and to study and to learn much. EB: So your brother in this class? No, his brother is not in this class. His brother is about 22 years old. He is in our club. EB: But he can communicate with his brother now. Yes, he can communicate with his brother because his brother is deaf. EB: Does everyone in your family speak sign language? He says yes, my family can speak in sign language. They have in their family about 2 or 3 deaf persons. EB: And what would you like to do when you’re older? He says I’d like to be a shopkeeper and to sold sandals and shoes. When my brother is not at the shop, I help my father and I sell sandals and shoes.

EB: This sign language, did you develop it yourself, or where did it come from? When we first came, we realised that Afghan deaf people, they already have their own language. So what we did was just recording it. So we did not add any new signs, but what we did is to get a group of people together and ask them, what’s the sign for this and for that, and they gave us the signs and we recorded into our dictionary. So we already produced a second edition of that dictionary and next year we will have a more comprehensive dictionary recorded by deaf people in Kabul, in Jalalabad and also in Peshawar. EB: Do deaf people throughout the country speak the same language? Because of logistic problems, it’s difficult to say. We believe that there are some similarities, but for those that are nearer to the west, for example in Heart, they may have more Iranian signs. But we have not done that kind of research yet at the moment. We are starting small. So as far as the eastern region and the central region is concerned, we will be producing this dictionary for education purposes, for communication purposes. EB: So in other words, you are always ensuring that there’s a standard language, a sign language that’s taught to all deaf Afghans. That is true, but we know that language is evolving thing, and it’s also the richness aspect of it. For example if we have two signs we will put those two signs or even three signs into the dictionary because the dictionary is a record of all words, of all signs, of all concepts. So in that sense, people can choose what sign they want to use. This language is a growing thing.

Page from a sign language textbook
Page from a sign language textbook

EB: OK, this is the most advanced class and you have five students here. There’s a blackboard what looked like very long sentences in Pashto. Is this what you are striving for all the children, to achieve this type of level? Yes, we would like to have deaf children to read and write and be literate so that they can have the whole world of information open to them. So that they can access to the information in written form. But at the moment we do not have provisions for class 7 and above. This is only a primary school and we only do education up to grade 6 and most deaf children after that they will learn a vocation like tailoring or carpentry or repair bicycles so there is no provision at the moment for secondary school. EB: But has he said yet what he wants to do? He wants to become a teacher for deaf children. EB: And you? He wants when I will be graduate, I want to go to a foreign country to learn more about subjects or something else. EB: About sign language or education in general? About English, general education. EB: And you? He says his name is Abz? Ahmad. He wants to when he finish this up to grade 12, he wants to become a computer operator. Yeah, he likes computer. EB: And you? His name is Faizmahmed, when he graduates from class 12, he wants to go to foreign country and become a doctor. EB: What type of doctor would you like to become? For whole. EB: A general practitioner. OK, and you? His father is a farmer and he wants to work with his father.

EB: Are all these children from Jalalabad or do they come from rural areas? All these children are from nearby Jalalabad. In the rural areas, like I said, they have their own deaf units. EB: So they commute every day? Yes, this is a day school and they commute every day. Residential schools are not very popular at the moment. We actually have village units, units in the village school where it is more integrated, where hearing teacher teaches a class of deaf children in sign language. The problem of full integration is because in a class of 60 children, the deaf child gets lost because he cannot hear. If they have a separate class where he’s operating in a different language, in their own language, in sign language, then they can absorb all the information and they can learn how to read and write.

EB: But generally there’s a very low priority in developing countries, particularly in a country like this one which has been at war for 20 years, for children with disabilities. Yes, that’s very true, because the attention would be given to normal children, so to speak, or the average child. Although the situation here is such that ordinary children do not get much of an education. I’m not sure about the policies in the country because we still do not have permission to integrate disabled children into ordinary schools so until people are aware of disabilities of disabled children that they have the right to an education, they have the right to integration. Unless the attitudes change and the provisions come, then we will not see much done for disabled children in this country. EB: But this is a slow process obviously. Oh obviously it’s a slow process, and of course a developing country has other priorities also. EB: But this should also be a priority. Yes, I think it is the right of every child whether disabled or non-disabled to have an education.

The Comprehensive Disabled Afghan Programme has also been trying to bring about greater integration of the disabled. Despite traditional attitudes, says Peter Coleridge, Afghan society is not actually opposed to the concept.

We are pushing at an open door in Afghanistan. We find maybe because of the Islamic background, which has a very strong charitable element to it, people are very willing actually to help marginalized people. We have a large number of volunteers in our programme, many of whom are women, who come forward quite happily to work with disabled people. And of course for women it means they can get out of the house. They can get involved in something which is socially useful and they can acquire a role and they can acquire skills and they can develop their reading skills and so forth. So in terms of gender balance and opportunities for women also, we see a lot of importance in this programme. EB: Does the CBR approach have one other advantage in that sense that you are training people and you’re basically soughing the seeds for the creation of a civil society in Afghanistan, on a small scale of course? Definitely we would see our programme fitting in with that. The local communities mobilised around local committees, that is groups of people within each district or village area who take responsibility for this part of their lives. And they will be school teachers or health workers or parents of disabled children who have a particular interest, and disabled people themselves who join these committees. And it ranges how seriously they take their work, but many of them take it very seriously indeed. EB: What about the reaction of disabled people themselves to the work that you are doing? We also encourage the formation of what we call DPOs, disabled people’s organisations, both at the national level and the regional level. There are probably now about 300 of them at the local level. There is an increasing sense of empowerment, that they can make groups, they can form groups and they can conduct their own activities. I mean, I think that we see the programme as a rights-based programme. And all the activities that we do are designed ultimately to give disabled people more rights. A child needs to go to school. A child needs to have a prosthesis, everybody needs certain things by right, and we try to provide those things within the programme.

On 3rd December, we will have this bicycle race in Afghanistan. EB: The 3rd of December is the day for the disabled. For the Disabled people. It’s the international day of disabled people. So disabled people or disabled children of Afghanistan should do something to their solidarity with disabled people of the world. So we can provide this opportunity that they participate in the cycle, in this bicycle race. We are expecting about 150 disabled children will participate. EB: Do some of these children go on to take part in the Paralympics for example? We participate in 1996 Paralympic Games, but since then we faced a little financial problems that we could not pay membership fees which was $400 each year. So as we don’t have enough extra funds to pay that, so this year unfortunately… EB: What do you think about that? I mean confused. Because in this country, Mr. Eric, you will see too many problems, like drought, poverty, lack of education, disabilities. So if they go at least, they can share their experiences, they can learn from each other. Now they are thinking that they are only isolated. EB: Can you tell me what happened after the Paralympics in 1996, when the children came back here? Did they talk to everyone about this? What was the reaction? The reaction was very positive because when they were arriving…because a large gathering of other disabled people, they come to say welcome to them. And they encourage them and they were quite happy that at least they were represented in Atlanta. They were quite happy, and all the people they were praying that they have should have a safe trip and good participation and to make friends for Afghanistan. And those disabled did this.

EB: Anything else you’d like to say? He says that he has a message for his country boys that they all should try their best to go to school and continue their education and to respect their parents and to respect the elder people and also he has a message to the world that do not forget the children of Afghanistan, like please help them to ride them bicycles to go to schools and provide them just a kind of help.

11-year-old Imra of the Afghan Amputee Bicyclists for Rehabilitation and Recreation, bringing an end to this special edition of A Good Life, produced by Eric Beauchemin. I’m Hélène Michaud. Join us again next week.