Situation for children with mental and physical health disabilities in Namibia

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1 Addressing mental and physical health disabilities and disorders in children and adolescents should be an international priority (WHO 2005). However, many countries do not allocate sufficient resources. Namibia is one such country even though the Government has recognised that mental health disabilities are a major cause of morbidity and mortality. The Government is well aware about the situation for people with disabilities - that they are often prevented from using public services and that there is a lack of awareness. The results are discrimination and isolation. Children with disabilities are kept home, can`t go to a school and teachers are not trained to assist these children. In their vision 2030 the Government mentions to improve the situation for people with disabilities: People living with disability are treated with dignity and given their due honour and respect. legislative, economic and social structures are in place, to eliminate marginalisation People living with disability are given the necessary assistance to enable them to participate effectively in education and employment opportunities. Still a long way to go 5% of people in Namibia have a disability. The major disabilities are blindness, deafness, impairment of speech, limb impairment and mental disabilities. 83% of people with mental health disabilities live in rural areas. The aim of this report is to learn more about the situation of children with disabilities and what services they can get in the Khomas Region, the Kavango Region and the Zambezi Region. 1

2 National disability Council Namibia NDCN The National Disability Council of Namibia was established by an Act of Parliament, aiming at uplifting the livelihood of people with disabilities in Namibia. They aim for equal opportunities in education, vocational training, recreational facilities for people with disabilities. The Council was further created to strengthen the implementation of programmes and activities to benefit people with disabilities. Some of the major challenges for people with disabilities faced in Namibia are accessibility to buildings, transport facilities, inclusion into socio-economic activities. National Federation of People with Disabilities in Namibia NFPDN Umbrella Organisation for people with disabilities Role of NFPDN: fight the poverty that people with disabilities are in and develop employment opportunities further accessibility to public buildings ensure education is offered at an appropriate level to all children with disabilities make health care and rehabilitation accessible support care givers appropriately What they do: empower organizations of people with disabilities counselling for jobs, HIV/AIDS, Gender, Abuse. training strategy Different Organisations for People with disabilities: Namibian Federation of the Visual Impaired (NFVI) Namibia National Association of the Deaf (NNAD) Namibian Association of People with Physical Disability (NAPPD) National Association of Differently Able Women (NADAWO) Disabled Youth Council of Namibia (DYCN) Namibian Association for Children with Disabilities (NACD) Non Governmental Organisations (NGO`s) Association for Children with Language, Speech and Hearing impairments of Namibia (CLaSH) EHAFO Training centre for adults with disabilities Oponganda Day Care Centre for Children with disabilities Cheshire Home Onyose Trust CBR Program and Day Care Program Rehabilitation for People with Disabilities The ministry of health and Social Services (MoHSS) has a responsibility to promote social integration for people with disabilities. Support is provided by: 2

3 Community Based Rehabilitation (CBR) CBR is a strategy utilizing local volunteers and resources to meet the needs of persons with disabilities in the communities, ensuring social integration and full participation. CBR volunteers in all the regions provide direct support or referral to appropriate resources for needed services through Regional Rehabilitation staff members of the Ministry. 3

4 More about the special Institution for children with disabilities Windhoek / Khomas Region Namibian Association of Children with Disabilities (NACD) What it offers: Counselling parental guidance and information for parents of children with disabilities Raise funds to support projects aimed at the realization of equal rights for children with disabilities Improve the integration of children with disabilities Regular home visit Monthly parent meeting Attending trainings and workshops on disability issues as well as capacity building issues Establishments of parents support groups Planning about a future day care centre Dagbreek School (Governmental school) The Dagbreek School is a special school for children with disabilities, for learners who are intellectually impaired. The school runs 2 beginners classes, 3 junior classes, 3 senior classes and 1 autism class. Dagbreek accommodates learners between the age of 6 and 18 years old and delivers a specialised service in teaching and development of learners who are intellectually disabled which includes learner with Down Syndrome, Autism, ADHD, Cerebral Palsy. The school accommodates about 120 learners and 28 learners in the hostel. There is a waiting list of more than 180 learners from all over Namibia. Dagbreek does not receive much financial assistance from the government. The school wouldn`t have made it so far without the different fundraising events throughout the years. 4

5 Moreson school Governmental school The second school for children with disabilities is in Khomasdal. Both Dagbreek and Moreson are situated in Windhoek. They are the only special schools for children with disabilities in the whole country. The waiting list has grown dramatically. And with the decentralisation the school only caters for learners of the Khomas Region. NISE (National Institut for Special Education) It is a Governmental School for hearing and visual impaired. The school takes children from all over the country and runs a hostel. They start from Pre-Primary up to grade 10. The learners are kept in small classes up to 8 children. The curriculum is the same as in the mainstream schools. From grade 10 they follow the mainstream school with interpreters in sign language and Braille. 5

6 Ehafo Ehafo was once a private institution for adults with disabilities. They offer vocational trainings and also run production units, like producing furniture, gardening. Since the Government took it over there is no more production on the place which means no jobs for those who are being trained in the vocational training centre. The future of this centre is insecure. Oponganda, Centre for Children with Disabilities The Oponganda project was established in 2001 and was registered as a welfare organisation in 2002 and is a day care centre. The centre cares for small children and young adults between the age of 2 and 23 years old with different disabilities. Most of the children are from the formally disadvantaged township and much marginalized group. Aims and objectives: To improve and develop conditions, socially as well as academically for children with mental and physically disabilities To empower parents of children with disabilities and care takers through training To establish an Early Intervention Centre offering sustainable services To foster cooperation and networking between NGO`s and the responsible Ministries 6

7 Katima Mulilo / Zambesi Region Cheshire Home Katima Mulilo Zambezi Region The Leonard Cheshire Foundation is an international charity organisation which supports people with physical disabilities. Part of their work focuses on helping children with disabilities to access education. In Namibia there are two Cheshire Homes (Katima Mulilo, Anamulenge Outapi) where children live and are cared for, so they are able to access schooling what would be otherwise impossible for them to reach. The Katima Mulilo home is run by a Polish nun and caters for about 30 children with various physically disabilities. Also a physiotherapist is placed in the home that provides rehabilitation services for the children. 7

8 Mainstream Foundation for children with and without disabilities Katima Mulilo Mainstream Foundation is a community-based NGO and a registered welfare organisation. It is situated in Katima Mulilo. Mainstream Foundation is committed to contribute to a society where each child with a disability has the right to education, rehabilitation, full inclusion and effective participation in society. This Organisation shall support, empower and promote the rights of children with disabilities and by providing them with an integrative and conducive environment for their physical, mental, social and spiritual wellbeing. Rundu / Kavango Region Special Units at the schools I visited two schools where they run a special Unit for children with difficulties in learning, hearing and visual impairments. One group of 15 children with different abilities and disabilities gathered together in a small storeroom where they got lessons from a very dedicated teacher. It is not a simple task to get into every child`s individual problem, but at least these children who can`t be part in the mainstream school, get a day structure and can be part of the society. 8

9 In the other special unit there were about 40 children from the age of 8 years to 20 years in a small classroom with not even enough table and chairs. Because of a lack of teachers there is only one teacher who cares for these kids with different special needs. 9

10 The teachers are doing a good job but they are overloaded by the amount of work. Children with disabilities don`t seem to have the same value as the others. Rehabilitation Department The ministry of health provides services for people with disabilities. But the Community Based Rehabilitation (CBR) post has been vacant for a long time. Problems and barriers Despite a very progressive legislation and a clear commitment from the government of Namibia, the majority of people with disabilities in Namibia do not access the same opportunities within the community as people without disabilities. Low accessibility to the education system Lack of rehabilitation services and vocational training No special schools or institutions for children with severe mental and physical disabilities Problems of transport/distance to the health facility Lack of specially trained people (teachers) Stigmatisation, fears and believes about people with disabilities Discrimination Fear of disease transmission Healthcare professionals have negative attitudes towards mental illness Fear that person may be dangerous Lack of rehabilitation programmes and facilities Many people believe that children with disabilities have been cursed by witchcraft Lack of information about mental health conditions Discrimination of parents Afraid that the child would be taken away, when the parents seek for assistance No respect for children with mental health disabilities Parents cannot afford to take a child for any follow-up appointments that are needed Lack of special schools or limited places Although the Ministry of Education is trying to promote inclusive education this can be problematic as children often tease learners with special needs. Furthermore the mainstream teachers are currently not sufficiently trained to work with children with special needs. 10

11 My work in Oponganda Since May 2013 I assist as a volunteer in the Centre for children with disabilities Oponganda. The children are collected by the manager of the centre with a minibus and in the afternoon she brings them home again. In the morning session we assemble the children in a circle; all children are part of it. We sing and play and try to activate them to participate. We also feed the children and try to train them to become independent. Most of them need a lot of assistance also for using the toilet. Unfortunately, there is not enough capacity to work with the children more individually to train certain behaviour and so the situation is often chaotic. A better understanding for children with disabilities would need special trained staff, workshops in that field and assistance from specially trained teachers. Later we do basic physiotherapeutic exercise with the children with cerebral palsy. It is very important to do the exercises every day to avoid contractures. 11

12 The others we try to keep occupied, playing in groups or individually. 12

13 Around 20 children are registered in Oponganda. We are only three staff members. Not enough staff is one of the problems, the second one is, we are not specially trained for this kind of work. I actually come from a different background but I know a lot about the work with children with disabilities, the other two ladies they have no profession. They are not used to deal with children with special needs, how to handle them, how to play with them and support them individually. They are learning by doing. Since I have no assignment there is no definition about my work here in Oponganda and this makes it difficult. I have to find out what is possible and acceptable to improve the situation without being offending. I can show what could be done by doing and demonstrating it and I think we are already improving a lot. I contacted the community based rehabilitation unit and organized a physiotherapist to show us the exercises and to teach us how to handle certain difficulties. This can be repeated at any time in future to update the knowledge of the staff at Oponganda. I see a lot of potential in the kind of work I am doing and there could be much more done with better organization, communication and support from the government. Therefore, I encourage the manager to contact the ministry of education to negotiate the acceptance of the Oponganda Centre as a special school and get the necessary support. Even the parents should be more involved, so we organized a parent s day, where we showed the parents what the children learn in this special school and how they can help them to make their life worthwhile. 13

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15 My Vision Having only nine specialist schools in the country is insufficient to meet the needs of all the children with disabilities in Namibia. Inclusive education should be promoted as well as special schools (day care centres, resource centres) for children with severe mental and physical disabilities, those who can`t be included in Mainstream School. A disabled child should have effective access to special education. Parents need support to help them learn to love and care for their children. Social workers should be trained to deal with such situations. Oponganda is as far as I know the only centre that cares for children with severe mental and physical disabilities in Windhoek. These children have the opportunity to be among other children, to learn about social life, to get inspired and stimulated, to have a day structure, to feel important and beloved, to have fun and make different experiences. It should be taken as an example to build up more institution like this - because every child has the right to education. A special school for special children. It should be taken up and being supported by the Ministry of Education and the Ministry of Health and Social Services. I can see potential for Interteam assignments in this field of work. To support the start of such a project like Oponganda in the North of Namibia, where there are no such institution yet, with specialists like Physiotherapists or Special Needs Teacher. To support the building and running of resource centres together with the government where all children with special needs can join education in their special fields. Development workers could support local people and train teachers for this special kind of work, further they could support the management in running such a resource centre. Interteam Windhoek, Namibia June