PAPER: Independent Living Movement in Developing Countries by Shoji Nakanishi

Posted on 30 December 2007. Filed under: Academic Papers and Research, Community Based Rehabilitation (CBR), Cross-Disability, East Asia Pacific Region, Guest Blogger, Latin America & Caribbean | Tags: Berkeley, Brazil, developing countries, disabilities, disability, disability and development, disability and international development, disabled, disabled people, Disabled People International Asia Pacific, DPI World Council, Independent Living Centers, Independent living movement, international development, Japan, Japan Council on Independent Living Centers, living independently, Malaysia, people with disabilities, Philippines, Rosangela Berman Bieler, Shoji Nakanishi, South Korea, Thailand |

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Independent Living Movement in Developing Countries

by Shoji Nakanishi
Disabled People International (DPI) Japan

It has been many years since experts of rehabilitation recommended training and educations to people with disabilities to enable them to get jobs as non disabled people do. The experts believe that independence means only economical independence. As a result, parents think it impossible for their disabled children to live independently in their communities. Parents tend to put these children into a residential institution for them to live permanently. Following these ideas, the government is promoting to build more institutions and to train more experts for people with disabilities.

The Independent living movement by severely disabled people in America denied institutions that lead to isolation and discrimination. In 1972 The First IL center was established in Berkeley, the second one in Houston, in 1974 the third in Boston. A lot of IL centers have come into the world in a very short time. All disabled people in the whole country were united, and then won the amendment of rehabilitation law in 1978. As a result, IL centers got great opportunities to get subsidies from the federal government. “Independent Living: From Social Movement to Analytic Paradigm”, An academic paper written by Gerben DeJong, published in 1978, drastically changed the way of thinking toward disabilities, from rehabilitation to independent living. With this paper, the philosophy of independent living was accepted as a social movement on a academic basis. These two events rapidly promoted the establishment of IL centers nationwide.

Independent Living Movement In Developed countries

The IL movement, which gave dreams and wishes to disabled persons, has grown to service provision systems by disabled peoples themselves and advocacy activities by IL centers in these 30 years in all developed countries, except the Oceania region.

Ed Roberts, the founder of the Center for Independent Living in Berkeley and other activists with disabilities said, “People with disabilities should live in communities.” “People with disabilities are neither patients to be cared for, children to be protected, nor Gods to be worshipped.” “People with disabilities themselves can identify their necessary assistance and manage it.” “People with disabilities are the victims of social prejudice rather than victims of disabilities.” This philosophy was soon accepted in many parts of the world. On the grounds of this philosophy, IL centers are providing these services below:

1. Dispatch of Personal Assistants.
• There are two ways of dispatching personal assistants; one is the way of direct dispatching like in Japan, another in the way of introducing through IL centers like in the U.S.
2. Peer Counselling
   • Counselling, talking or sessions among peers who have the same or similar experiences of disabilities.
3. Independent Living Skill Training
4. Advocacy Activities
5. Providing information
   • Housing and social welfare referral are included.

Now the organizations of IL centers are established in each country and region, such as NCIL in America, CAILC in Canada, JIL in Japan, and ENIL in Europe. In 1999 The first summit of World independent Living was held in Washington D.C, U.S.A . Since then, three summits have taken place in different areas where a great number of disabled leaders, including leaders from developing countries became involved.

Conditions concerning Independent Living in developing countries

The Idea of independent living, which insists on self-decision and self-management, also fascinated people with disabilities in developing countries. But because of lack of social resources, it is thought to be difficult in developing countries to achieve environments where there are enough services and accessibilities. Moreover, quite a few people thought by mistake that independence means only economical independence, so that they believed that nobody can live an independent life except for a lightly disabled person. It is nearly impossible for people with disabilities to get jobs in Asia, where only 5 or 10 percent of disabled children can have school education.

As a result, almost all developing countries tried to get disabled people to be independent through CBR (Community based rehabilitation) produced by experts, in the same period of the IL movement. Services based on institutions could be only beneficial for disabled people living in urban areas. The main target of CBR is for disabled people who live in rural areas, occupying 7 or8 percent of the total population. Non-disabled people in their communities were voluntaries trained as CBR workers, and then they did some simple rehabilitation work and help the daily lives for disabled people. Indeed, the quality of life for disabled persons might get improved to some extent, through basic physical training, walking training, sign language education, inclusion by CBR workers, and financial aids of private companies like Micro Credit. But CBR did not necessarily bring independent living for disabled persons though disabled persons had joined as official members since the beginning of providing services. That is because CBR was firstly positioned as extentions of institutions, so that disabled persons were kept under control or management of experts without disabilities.

It is often the case that disabled people who have loved the idea of IL also name their activities IL in some developing countries. For example, a certain disability organization In Mexico established a new organization named “International Organization of Independent Living for People With Disabilities”, arranging the curriculum for disabled people which included lessons about fitness, physiology, swimming, manipulation of wheelchair, driving of remodeled cars, sexuality and family life, urology, training of daily living activities etc. In Thailand, one of the staff with disabilities working at Sirindorn National Medical Rehabilitation Center suggested the Independent Living Unit, providing much the same program as Mexico’s organization did. Even though these trials may not always share the same meaning of original independent living, it indicates that there are also many disabled people having a try at independent living by themselves, in developing countries.

Scheme for spreading IL in developing countries

In 1980, American disabled people who had got involved in the IL movement began to act in other countries to spread the philosophy abroad. Nowadays, Japan is taking charge of propagation of IL in the Asian region, while in America, IL centers or other organizations like Mobility International are inviting other countries’ disabled leaders to their training seminars.

One of 4 activities is often adopted as a way of spreading the IL philosophy in developing countries; first is promoting theoretical framework of IL, second, advocacy, third, participation of severely disabled persons in self-help organizations, and the last, showing a role model as an example of IL.

1. Activity to promote the theoretical framework of IL
　　Firstly it is necessary to correct the mistake about IL that independence means doing everything alone without any help. In spite of someone’s help, it is regarded as IL, if only self-decision and self-management can be done. This idea welcomes people with disabilities as “very good news”. But, in most cases, this acceptance does not immediately bring grassroot activities. For instance, a lot of disabled people were excited to meet American activists who came to Japan for an IL promotion tour in 1982, but the IL movement in Japan did not start untill the first IL center was established in 1986. It is very important to follow up on their experiences.

The first IL seminar in Asia was held in Bacolod, the Philippines in 1994, mainly promoted by STIL, Sweden and the Human Care Association, Japan. Three Asian persons with quadriplegia joined this seminar. After the seminar, Motab from Bangladesh tried to expand his job at the Center for the Rehabilitation of the Paralyzed to the activity of independent living but in vain because of his death 3 years ago. Male participants from the Philippines, all of whom had already married, got quite interested in the IL movement, but they found it difficult to make a movement in their own country, because they had to prepare for their family before they join the movement. On the other hand, Topong from Thailand, on the grounds of the ideals of the IL movement, held a demonstration for better access of Sky Train, and educated other organizations in local areas. The Human Care Association supported his activities, and then offered him to come to Japan for training

Famous disabled activists participated in the 1999’s seminar in Malaysia held by the Asia Disability Institute. One of them was Christine Lee, who had staged a demonstration for access of the mono railway at the risk of being arrested. All participants were wildly enthusiastic on the last day of the seminar, and promised each other to promote the IL movement more actively from now on. But actually, few of them were able to increase their activities in the IL movement. There may be two reasons. One is most of the participants have their own jobs and have no time for the IL movement; the other is that severely disabled persons who really need IL have not joined the movement yet.

Promoting activities are very essential to support and spread the IL movement

2. Advocacy
　　 The IL movement in Brazil was based on advocacy. Rosangela Berman Bieler, a Brazilian woman with quadriplegic who happened to visit an IL center in America was so impressed with its philosophy that she joined the IL movement. In 1988 CVIRJ, the first IL center in Brazil, was establish by her in Rio de Janeiro. CVIRJ began to start a movement for easy access to the city, such as getting rid of steps on side walks. The problem of accessibility is very meanful not only because it is a problem that applies to all kinds of disabled people, but also because it will bring visible outcomes as advocacy. The IL center in Brazil made the movement more powerful by keeping contact with IL centers in America. Now in Brazil, there are 25 IL centers established, and the national union of IL centers has been united.

In South Korea, the IL movement has made rapid progress in a short time, because the Korean people getting involved with the IL movement have already created activities of advocacy on a large scale. Chon Manfu, a severely disabled person who applied for the role model of IL in 2000, was empowered through the experiences of joining big demonstration in 2001 and a long-term hunger strike in May 2002, triggered by the death of a wheelchair user at a subway station. These events were arranged by Pack Gyoung Souk, the principal of a night school for the disabled people. A lot of his students, who have studied IL, are taking part in the IL movement, which is one of the reasons why the Korean IL movement has such power. Now, the main issue in Korea is to train disabled people as peer counselors. The physical and mental conditions for developing IL in Korea are being prepared; 3 IL centers in Japan, Human Care Association, CIL Tachikawa, and HANDS Setagaya, collaborated with each other to establish a new project team that dispatches peer counselors to Korea several times a year and provides long-term training in Japan for Korean disabled leaders. As a result, some of them have reached the high standard of peer counselors that JIL is setting. There are 5 IL centers in Korea.

3. Participation of severely disabled persons in self-help groups

In Thailand, many disabled people used to sell lottery as a job, which made enough money to prepare for their own family. But because of this job, the disability movement did not grow among people with disabilities in Thailand. Under these circumstances, Topong, as I said before, thought it was only the IL movement that would change the environment of disabled people in Thailand. He tried to promote the IL movement in collaboration with 3 organizations of disabled people, Nontabri,Chonbri,Nakonpatom, three of which were very conscious about the rights of people with disabilities. To support his activities, the Human Care Association invited him to come to Japan for an IL seminar.

Each of these three organizations were democratic self-help groups, which provided home visiting services for disabled persons. Leaders of these organizations were willing to accept the idea of IL. The first step of a three year project is to open a seminar by Japanese disabled leaders, ten participants from three organizations were all studying hard, but none of them were severely disabled. So, the project team gave a task for them that they should find at least five severely disabled persons and take them outside their homes until the next years’ seminar was held.

After this, three organizations began to train students to be a voluntary staff, and ask them to take severely disabled persons outside. Some of disabled persons went outside for the first time in their lives; some of them were strogly opposed by their families, so that they were forced to refuse staff visits; some of them gave up to go outside because of their bad health; some of them had lifters fixed in their bathroom by staff who saw families lift the disabled person with great difficulty. As a result, many of them attended the peer counselling workshop held in 2002 empowered physically and mentally. As they are finished learning skills of managing an IL center in 2003-2004 year, the real activities are ready to start.

4. Showing role model of IL

Young disabled persons who belongs to the MileStone Society in Pakistan came to Japan for the Duskin Training Program, including the 9 month IL seminar at several IL centers, such as Human Care Association and Main Stream Association. It is almost a year since they have gone back to Pakistan and begun to start the IL movement. They looked around Lahore to discover severely disabled persons confined in their homes, and persuade them to attend training workshops held at an office. They asked some promising participants to experience IL in a room in the corner of the office.

In the end, a young girl with muscular dystrophy made a decision to live independently. She learned various IL skills such as how to take proper care from others and how to tell personal assistants what she wanted her PA to do by actually living in a special room arranged in a corner of her house. In the day time, now she works as a member of the Life IL Center the renamed office, riding in a power wheel chair taken from Japan. It is very meaningful that she began to live independently for the first time in Pakistan, moreover in such an Islamic society, where women are likely to be conservative. After her independence, two male disabled persons, who have been encouraged by her, want and even practice now to live independently.

Spreading the correct philosophy of IL

It is true that more and more people have heard about IL, and especially in developing countries, where their expectation toward IL is getting bigger and bigger. Nevertheless, most of them have given up their dreams, making excuses like these: “We have no resources to use in our country.” “Prejudices against disabled people are still deeply rooted.” “Government does not still prepare sufficient welfare systems.”

　　One of the strategies to achieve the targets of the Biwako Millennium Framework for Action is “Strengthened community-based approaches for the prevention of causes of disability, rehabilitation and empowerment of persons with disabilities.” It says that “Many developing countries in the region are now beginning to augment and replace traditional institutional and centralized rehabilitation programmes and projects with approaches better suited to their social and economic environments of poverty, high unemployment and limited resources for social services. Community-based rehabilitation programmes form the hub of such strategies. The community-based approach is particularly appropriate for the prevention of causes of disability, early identification and intervention of children with disabilities, reaching out to persons with disabilities in rural areas, raising awareness and advocacy for the inclusion of persons with disabilities in all activities in the community, including social, cultural and religious activities. Education, training and employment needs could also be met by this approach. It is essential that persons with disabilities exercise choice and control over initiatives for community-based rehabilitation..” It even recommends in Strategy 10 that “Governments, in collaboration with organizations of persons with disabilities and civil society organizations, should immediately develop national policies, if that has not yet been done, to promote community-based approaches for the prevention of causes of disability, for rehabilitation and for the empowerment of persons with disabilities. Community based rehabilitation (CBR) perspectives should reflect a human rights approach and be modeled on the independent living concept, which includes peer counselling.”

Many people tend to think it nearly impossible to introduce IL to their countries. Naturally the idea of IL can apply to all disabled people in all countries by all ages. The problem is whether you can have the courage of doing what you have not done yet, and whether you have many peers and friends who will support your activity. Pioneers have a lot of difficulties, but have a great impact on other people. Nowadays a variety of IL programs and seminars are prepared for such people. People in developed countries including ＵＳ are ready to assist you to be a leader of IL movement. We are showing the achievements and good news of IL at all times.

I first learned about this paper when Ghulam Nabi Nazimani passed it along.

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