boyce.doc - COMMUNITY BASED REHABILITATION FOR CHILDREN IN...

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COMMUNITY BASED REHABILITATION FOR CHILDREN IN NEPAL William Boyce*, John Paterson** ABSTRACT The purpose of this paper is to better understand some important principles and CBR programming practices that are required for children with disabilities. Although much of the attention of CBR programming worldwide has been in concern for children, (this is distinguished from disability self-help and advocacy groups that have been concerned with adults) there is little analysis on how and why these approaches differ. The trend in current CBR philosophy, and in more recent "social model" programmes that aim to include adults with disabilities in community-wide development initiatives, should be examined to determine whether this will meet the expressed needs of families and children with disabilities. Nepal is an example of a developing country in which these issues are important. INTRODUCTION NEPAL Nepal is a small landlocked country, lying between India and the Tibetan Autonomous Region of China. Geographically, Nepal is comprised of three major areas. The south, known as the Terai, is a comparatively low region of tillable land, swamps, and forests that provide valuable timber and is bordered by India. In the north are the Himalayas, including Mt. Everest (8,856 m), the world's highest peak on the border of Tibet (China). Central Nepal, an area of moderately high mountains, contains the Kathmandu valley, the country's most densely populated region and its administrative, economic, and cultural centre. The capital and largest city is Kathmandu (population: 535,000). Nepal is one of the poorest countries in the world with a per capita income of US$219 and an infant mortality rate of 104 per 1000 people (compared to 4 per 1000 in Singapore). Men and women are expected to live 57 years. It has a very low literacy rate of 57.6% for men and 20.7% for women. Trade with India dominates Nepal's economy. The poor economic situation is due to many factors: the small amount of arable land (17%), poor transportation networks due to the inaccessible terrain, an uneducated and unskilled work force, economic exploitation and corruption, and political instability. In recent years, significant deforestation and a growing urban population have greatly stressed the country (1). The population (25 million) of Nepal arises from an intermingling of cultures: the Mongolians, who migrated from the north (especially Tibet), and the peoples who came from the Ganges plain in the south. The chief ethnic groups are the Brahmins, Newars, Bhotias, and tribal groups (e.g. Gurung, Tamang, Limbu, Rai, Sherpa) and other caste groups. There are approximately 96,500 Bhutanese refugees in Nepal. Nepali is the country's official language. English, Munda and various Indo-Aryan dialects are also spoken. About 90% of the people are Hindu, with small minorities of Tibetan Buddhists and Muslims. Tribal and caste distinctions are still important, and Brahmins (the priestly class) retain great political influence. The royal family is Hindu and has been the subject of a recent tragedy resulting in further political instability.
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