USAID Disability Program Lifts Local Services to International Standards
Five year initiative assisted nearly 10,000 patients from Jaffna to Tangalle
By Zack Taylor
GALLE – Sixteen-year-old Sandun Ranga knows all too well that disability is often a consequence of tragedy. A student about to sit for his O-level examinations last year, Sandun commuted to and from school by rail. One day, horseplay with friends resulted in his falling under the wheels of the train, crushing both his legs.
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| Sandun Ranga stands tall with prosthetic limbs at the Southern Center for the Disabled in Galle. Photo: Courtesy Motivation |
“After my accident, I was very unsure about my future,” Sandun said recently, standing again assisted only by crutches. “People came to the hospital and explained to me how I still have a life to look forward to. I can have a happy future.”
Success in cases such as Sandun’s illustrates the effectiveness of the holistic approach to disability services: seeing a patient through recovery, fitting of prosthetics using the latest technology, and rehabilitation therapy that permits patients to resume productive lives. All elements are key to successful services for the disabled.
The SCD didn’t always operate at this level, however. Back in 2002, it consisted of one manager and two technicians sitting on the floor of a two-room shack, pounding sheets of aluminum on anvils into crude prosthetic limbs. It was a far cry from the fully equipped facility of today that is staffed with a complement of specialists trained in fabricating state-of-the art, customized mobility devices. Today, SCD provides clients with a full range of services including counseling, rehabilitative therapy, and even career guidance capable of providing life-restoring services to thousands of patients like Sandun.
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An applicant for employment outlines his skills at |
Such a transformation was possible after the SCD became a partner organization of the Disability Support Program, a five-year, $4.4 million initiative to improve services for the disabled in Sri Lanka funded by the U.S. Agency for International Development (USAID). SCD is one of six grassroots organization facilities across the country that received technical assistance and training from the Motivation Charitable Trust, a U.K.-based organization and USAID prime implementing partner. Motivation is dedicated to meeting the needs of disabled people all over the world. The program was made possible by the Leahy War Victims Fund, established by the U.S. Congress in 1989 to assist people who have suffered at the hands of armed conflict.
“The change in some of our partner organizations has been like day and night,” said Program Director Thomas Keolker. “These were all just little grassroots organizations that have been built up to the point where they can maintain international standards of service.”
In Sri Lanka, the protracted conflict, dangerous roads, and poverty all contribute to a high rate of disability – estimates indicate as many as one in ten. Health services struggled to keep up with the latest advances in mobility products and services such as prosthetic and orthotic devices. Local disability organizations were limited to low-tech, low-cost products; a lack of physical and occupational therapists was also a major constraint to meeting needs of this vulnerable population.
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Disability touches Sri Lankans of all ages at this therapy |
Over the past five years, USAID’s program has attempted to fill this gap. The program has assisted nearly 10,000 people, and imbued its six partner organizations with not only an understanding of the latest in technology, but also an approach that helps disabled people with the emotional, as well as practical, complexities of living with their conditions.
Additional partners include the Jaipur Center for Disability Rehabilitation in Jaffna, the Center for the Handicapped in Kandy, Navajeevana in Tangalle, Rehab Lanka in Colombo, and the Spinal Injuries Association in Ragama. All have risen to international standards during the life of the program, and will carry on long after it closes. Motivation likewise continues to implement projects on behalf of disabled Sri Lankans.
“The program has helped organizations who deal with the disabled in Sri Lanka to understand how important it is to address the broader issues,” Keolker said. “We have also tried to assure that our partner organizations can sustain these activities after the program finishes.”
To that end, USAID sent a group of Sri Lankan prosthetists to a three year program in Cambodia, a country with a similarly high rate of conflict-related amputees, to receive training on technology heretofore unavailable in Sri Lanka. The program continued to mentor the young professionals for a year after their return to the island.
“While we were overseas we learned the new technology and how to teach others in their clinical workshop activities, but since we’ve returned, our training focused on management functions to address patient needs from arrival through follow-up aftercare,” said internationally-trained prosthetist-orthotist Nadeera Samasekara. “We see so many psychological issues related to disability; we are counselors as much as technical specialists.”
On the outskirts of Colombo, Rehab Lanka provided disabled Sri Lankans with skills needed for employment and reintegration into society. Trainees from all over the country spend four months honing their skills in one of the many trades the center teaches, such as welding and apparel.
The program also teaches resume writing and interview techniques, and provides other peer support activities to help trainees find steady employment. Trainees become more aware of their fundamental rights (e.g., education, employment, among other services) to assist them in taking their rightful places as functioning members of society and to help them break out of the cycle of poverty to which the disabled are so susceptible.
Impact on public policy is another strong legacy of the program. A key member of a consortium that developed the Access for All initiative, Motivation advocated for new statutes stipulating that all reconstruction of tsunami-damaged public buildings, and that within seven years all new public facilities will include features such as wheelchair ramps and disabled-friendly bathrooms. To set an example for architects and builders, USAID funded a special $500,000 initiative through Motivation to upgrade nine hospitals and facilities for the disabled in tsunami affected districts.
“We are rightly proud of USAID’s contribution to assisting the disabled over the last five years,” said Mission Director Rebecca Cohn. “The level of technical expertise and provision of service in the six partner clinics have attained are permanent improvements to this important sector of the health care service community in Sri Lanka.”
A breakdown of DSP beneficiaries testifies to its reach into the disabled community. About 4,000 patients received prosthetic limbs, and 1,500 spinal and upper limb orthotic devices. More than 7,000 received rehabilitative physiotherapy. The program supplied nearly 300 wheelchairs, 61 motorized tricycles, and 700 walking aids. USAID support has facilitated Rehab Lanka’s export of their wheelchairs to foreign countries, boosting its sustainability. A series of annual job fairs placed more than 200 disabled persons into employment, and perhaps more importantly opened the eyes of employers to the fact that this community can play an effective part in the workforce despite ability limitations.
“Access for the disabled not only helps our community but society at large,” said DSP beneficiary Ousten Silva, aged 80. Blind from the age of six, Mr. Silva receives services from the Sarana Blind Elders Home in Tangalle. “With proper access to education and services,” he said, “we can reach our potential and contribute to science, the arts, and the economic growth of the country.”