Handicap International experience in Afghanistan - CBM

Table 5: Yearly Average Expenses (AFAs)ExpensesPhysicalDisabilityAverageCostTypes of Disability in 5 categoriesSensorialDisabilityAverageCostMentalDisabilityAverageCostAssociatedDisabilitiesAverageCostEpilepsy/SeizuresAverageCostCause of Disability in 3 categoriesLandmine/UXOSurvivorsAverageCostOtherWarSurvivorsAverageCostOtherCauses:Disease,Accident,AverageCostNon-DisabledNon-DisabledAverageCostMedication 1674.2 1950.5 2019.4 1230.3 1767.4 2912.7 2190.0 1595.6 531.2Transportation 396.2 608.9 523.9 911.6 600.0 267.5 146.1 214.1 101.0Fee 308.4 273.5 95.2 177.5 142.1 134.4 121.2 257.8 50.3Tests 224.2 285.3 76.2 154.9 181.2 347.8 662.1 252.3 40.7Food 266.8 496.6 95.6 247.4 234.3 579.8 612.8 538.9 33.4Amulets 40.7 83.4 178.6 271.8 445.8 25.5 67.4 185.6 32.2Caretaker 19.6 0.2 0.0 0.0 2.8 0.0 0.0 9.5 0.1Equipment 0.1 0.4 0.0 5.2 2.8 0.0 0.0 1.4 0.8Other 0.1 0.2 0.0 0.0 31.6 0.0 0.0 7.3 11.1All Expenses 3516.5 4015.3 2998.6 3262.2 3505.9 4354.0 4598.2 3376.2 833.6Conclusions & RecommendationsTo Sum Up:• Generally, barriers in ability to carry out daily activities are related directly to the type of disability theindividual has. No unexpected obstacle has been identified in the ability of persons with disabilities toperform their daily self-care tasks within the household.• Working in the fields and outside of the compound is a major concern for persons with disability. This canultimately affect their ability to produce food and engage in income generating activities.• Mental health is a significant challenge identified in this survey, especially for women.• Persons with disability access health services regularly, particularly in the private sector, and, to a lesserextent health centres and hospitals. A large proportion of persons with disability resulting from unidentifiedcauses turn to religion through mullahs to address illnesses. Lay beliefs regarding non-physical forms ofdisability are prevalent and often lead to a lack of knowledge regarding what can be done.• Health costs are significantly higher for persons with disability.Steps Ahead:Awareness Regarding Mental Forms of DisabilityIt is evident that a number of non-physical disabilities (especially mental form) that are believed to be causedby supernatural forces, djins and evil forces, are still cured by traditional methods and healers. Awarenessregarding these is imperative in order to improve the living conditions of persons with disability, and fightharmful practices that can result from these beliefs. On the field, it was often noticed that there was a genuineconcern for persons with non-physical disabilities, but often accompanied by a complete lack of knowledgeregarding what can be done. The belief that these disabilities can be cured is still very strong which leadsfamilies to look for a “miracle” or “magical” solutions. Again, any campaign of awareness and sensitizationwould need to work on the beliefs and acceptance of a given condition, as well as try to avoid giving focusto the causes. Religious and community leaders are the major actors to get involved because of the influenceand trust from which they benefit within communities.Awareness regarding mental disability also needs to be strengthened within trainings for health professionalsand workers.30 Understanding the Challenge Ahead