Handicap International experience in Afghanistan - CBM

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Table 4: Proportion of Persons with Disability Able to Carry out Tasks Outsidethe House by Main Types of Disabilities(Data presented below excludes respondents under the age of 8)Tasks Outside theHouse or CompoundType of DisabilityYes(%)Yes withDifficulty(%)No(%)Climb StairsGo to the Bazaar/Shop on Your OwnCarry Heavy ThingsWork in the FieldRide a Bicycle oran AnimalPhysical Disability 19.0 42.0 38.9Sensorial Disability 56.1 15.7 28.3Mental Disability 76.7 10.5 12.8Epilepsy/Seizures 80.9 16.3 2.8Associated Disabilities 35.6 27.8 36.7All Together 46.9 26.5 26.7Physical Disability 23.6 46.3 30.1Sensorial Disability 46.9 17.9 35.3Mental Disability 54.0 10.3 35.6Epilepsy/Seizures 74.2 9.6 16.3Associated Disabilities 32.2 17.8 50.0All Together 42.6 26.3 31.1Physical Disability 6.8 27.0 66.2Sensorial Disability 48.2 8.9 42.9Mental Disability 55.2 10.3 34.5Epilepsy/Seizures 74.7 9.0 16.3Associated Disabilities 17.8 15.6 66.7All Together 35.4 16.6 48.0Physical Disability 6.8 22.2 71.0Sensorial Disability 34.4 6.7 58.9Mental Disability 28.7 9.2 62.1Epilepsy/Seizures 49.4 6.7 43.8Associated Disabilities 10.0 6.7 83.3All Together 24.0 12.7 63.3Physical Disability 16.2 16.8 67.0Sensorial Disability 29.9 7.6 62.5Mental Disability 29.9 2.3 67.8Epilepsy/Seizures 50.0 5.6 44.4Associated disabilities 13.3 5.6 81.1All Together 27.0 10.0 63.0• The persons who are paralysed or have multiple physical disabilities face difficulty in all the tasks.The proportion is consistently above 85% for those paralysed, and 70% for persons with associateddisabilities. The percentages are even higher for carrying heavy things, working in the field or ridingbicycle or animals.Regarding persons with sensorial disabilities, findings show that:• Those having visual impairment have greater difficulty with all tasks over those with other sensorialimpairment.20 Understanding the Challenge Ahead
• For all persons with sensorial impairments the greatest difficulties encountered are for working in thefield and riding a bicycle or an animal. This is partly due to the fact that women are not allowed to workoutside the house in remote rural areas.In contrast to the above, people having mental and intellectual disability, as well as the cases of epilepsy andother forms of seizures, are more able to perform duties outside the house, with the exception of workingin the field and riding animals or bicycles. Less than 30% people with mental or intellectual impairmentand 50.0% persons affected by epilepsy/seizures are able to perform these tasks. Here again, it is highlylikely that the fact that a majority of persons in this category are females also has an impact; gender normsdetermine which tasks are not to be carried out by women outside the house.Mental Health of Afghans with DisabilityIt is believed that a large number of Afghans indicate having high levels of mental distress, which could meananxiety, depression, trauma, stress, etc. A few studies have looked at this issue in particular for the overall.population 19 . Our objective in this section is to present an overview of what the mental health indicators looklike. However, in order to present a coherent picture of mental health of Afghans with disability we choseto ask questions focusing on a few categories that came up as being important after discussion with otherpartners, as well as pre-tests. There is, inevitably, an overlap between some forms of disability identified bythe screening, and certain queries of the health questionnaire.The following section reports the responses of persons with disabilities to questions dealing with mentaldistress. For clarity we have divided this analysis into 3 major fields:• Behavioural problems which consist of 2 main domains: isolation/withdrawal and violence;• Problems related to communication and interaction with others;• Depression and anxiety signs.Before presenting the findings, it is important to stress that all the questions regarding some psychologicalor social difficulty emphasised the lack of identifiable reason for the problem. This was important in order todifferentiate a temporary problem, linked to a specific event or incident, as opposed to a recurrent or chronicproblem.Non-Disabled and Persons with DisabilityThe first affirmation that can be made is that the proportion of persons with disability showing signs of mentaldistress is much higher than the proportion of non-disabled showing the same signs in the recent past.Figure 9 clearly shows that the difference between persons with disability and non-disabled persons isconsiderable with regard to mental distress indicators. The items where the proportion of non-disabled ishighest are the ones linked to anxiety and depressive signs. An analysis by type of difficulty provides a betterunderstanding of the situation.Behavioural Problems: Isolation, Sadness, Fear and ViolenceThis part reports the responses of persons who suffer from behavioural problems such as isolation andwithdrawal from others, violent reaction to outside solicitations and pressure, difficulty in communicating, andanxiety or depression. All these items are examined below.19RASEKH Z., BAUER H.M., MANOS M.M., IACOPINO V. (1998) “Women Health and Human Rights in Afghanistan”, Journal of AmericanMedical Association, 1998, no. 280, pp. 449-55.CARDOZO B.L., BILUKHA O.O., CRAWFORD C.A., SHAIKH I., WOLFE M.I., GERBER M.L., ANDERSON M. (2004), “Mental Health, SocialFunctioning, and Disability in Post-War Afghanistan”, Journal of American Medical Association, August 4, 2004; no. 292, pp. 575 - 84.SCHOLTE W.F. OLFF M., VENTEVOGEL P., VRIES (de) G. J., JANSVELD E., CARDOSO B.L., GOTWAY CRAWFORD C.A. (2004). “MentalHealth Symptoms Following War and Repression in Eastern Afghanistan”, Journal of American Medical Association, no. 292, pp. 585-93.The Health Picture21
Page 3 and 4: Islamic Republic of AfghanistanUNDE
Page 5 and 6: ContentsAcknowledgementsAbbreviatio
Page 8: Figure 25 : Retention, Transition a
Page 11 and 12: AbbreviationsAFAs : AfghanisBPHS :
Page 13 and 14: PrefaceThe National Disability Surv
Page 15: IntroductionAs the process of recon
Page 18 and 19: Figure 1. Sampling Stages of NDSA1s
Page 20 and 21: A variety of subjects and fields ad
Page 22 and 23: • Beliefs and expectations of wha
Page 24 and 25: Prevalence Threshold with Regard to
Page 26 and 27: The proportion of persons with disa
Page 28 and 29: Mental disability shows a much more
Page 30 and 31: The effectiveprevalencerate of seve
Page 32 and 33: to a maximum of 37.4% unable to coo
Page 34 and 35: Table 3. Proportion of Persons with
Page 38 and 39: Figure 9. Distribution of Persons w
Page 40 and 41: Figure 12: Distribution of Persons
Page 42 and 43: Comparing the situation between mal
Page 44 and 45: Figure 17. Number of Visits to Heal
Page 46 and 47: Table 5: Yearly Average Expenses (A
Page 48 and 49: 32 Understanding the Challenge Ahea
Page 50 and 51: A crucial aspect that influences ac
Page 52 and 53: Table 6 highlights the advantage th
Page 54 and 55: Figure 26: Retention, Transition an
Page 56 and 57: to take this into consideration whe
Page 58 and 59: • Boys with physical disability a
Page 64 and 65: to others: usually they benefit fro
Page 66 and 67: Figure 37: Distribution of Active P
Page 70 and 71: According to NRVA 2003, poverty is
Page 72 and 73: means that the average living space
Page 76 and 77: Figure 46: Distribution of Househol
Page 80 and 81: The inability tobear children is am
Page 82 and 83: The situation is somewhat different
Page 86 and 87:
706050• Landmine/UXO Survivors•
Page 88 and 89:
ConclusionInclusion is a major fact
Page 90 and 91:
of persons with disability 48 . Thi
Page 92 and 93:
GHOSH N., MOHIT A., MURTHY R.S. (20
Page 95:
The National Disability Survey in A
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Handicap International experience in Afghanistan - CBM

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