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Ladakh

In Conversation With Reach Ladakh

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In Conversation with Dr. Tsering Dorjay, Manager Rewa Society
By Stanzin Dasal, Tuesday, August 1, 2017

LEH:
Giving a new hope for many people with disability, Rewa Society started in the year 2007 in Leh, Ladakh.  The society was established seeing the desperate need of physiotherapy for the children with disability to improve and ensure quality living.  Around 400 people including the children and adults of various parts of Ladakh are helped and supported by the Rewa Society.

To learn more and talk about the people with disability, we have Dr. Tsering Dorjay, Manager, Rewa society in this issue.  He is a physiotherapist with 7 years work experience with Handicap International Medicine Sanfrontier and Chattisgarh Government. 
 
He has been working with the Physical rehabilitation for people with disability in the conflict-affected area of Dantewada, Sukma of Chattisgarh and Kashmir valley.

Q. How Rewa society came into existence and what is its role?

Rewa Society is an initiative to serve special need and care to the children with disability of Ladakh. In the year 2007, it was founded in Leh, Ladakh and became a registered NGO since February 2011. The society started out of with an initiative of the German NGO Ladakh-Hilfe. 
 
The founder of Ladakh-Hilfe, Karola Wood, Physiotherapist, came to explore Ladakh and during her visit to Lingshed village she came across with children with disability and realised the importance and a desperate need of physiotherapy.  Since from the year, 2003 she had started working with disabled children in Ladakh.
 
She started NGO Ladakh-Hilfe in Germany to raise funds in order to help and support the children with disability in Ladakh. With the financial help a much-needed therapy centre’ Rewa Ability Center’ was established in Leh to provide the best quality service and facility. 

From 2009-11 we started identifying children’s from different far flung places of Ladakh region. She recruited professional volunteers from Europe.

In the year 2010, we found another centre in Kargil in collaboration with the local school to meet the need of the disabled in Kargil district. The Munshi Habibullah Mission School, Kargil offers inclusion and integration of special needs children in their curriculum and integrates them fully in a regular class for some subjects, differing with each child. 

Our role is to provide physical therapy, occupational therapy, psychosocial service, special educator and distribution of aids and appliances. From the year 2012, we have also started organising surgical camps in various villages where we identify and screen people with disability and further intervene in the surgery. The doctors from outside are engaged and the surgeries are done in SNM Hospital. A huge amount of funds are bear by the society, thus as a sustainable approach, we have a plan to utilize the local resources available in Ladakh. 

We also work with all Government Institutions and NGOs who serve the children with special needs.

Q.  At present, how many students are enrolled and what are the most common types of disability found in Ladakh? Reason.

At present in Leh 190 students are treated in the Rewa Ability Center, Leh. The data of Kargil is not updated but adding both the district approximately 400 people with disability including the children and adult are identified and helped.  We put every effort to help and support maximum people with disability but are more focused on the children as we don’t have the required and specified facilities for the adults. But yes, we are focusing and planning to facilitate the adult also.

Till now as per our survey, we have found that in maximum cases we have a problem of Cerebral palsy. Cerebral palsy is a disorder of movement, muscle tone or posture that is caused by damage that occurs to the immature, developing brain, most often before birth.

This is mainly caused and is more prone in pre-pregnancy, during and post delivery period.  A child suffers from this when in the womb a mother is addicted to drugs or suffers from any addiction the consumption of such leads to the damage of the child’s brain. During the delivery can also cause the damage because many times a child is given birth forcibly or with some complications and lack of oxygen. In after delivery case, a child suffers from any injury or accidents.

Such cases are mostly found in the far flung areas where people couldn’t able or prefers home delivery.  Lack of institutional delivery becomes the more reason for the Cerebral Palsy. Along with this, we have also had many associated problems.  
 
As for now, we don’t have a written or an exact data of the maximum cases and causes but this year we will be conducting the survey on it. 

Q. Do you provide these facilities to the children of remote areas or are you focusing on Leh only?

Yes, we go to the far-flung villages along with Leh to identify and extend every possible help and support. The only difference is that the regular intervention and services cannot be provided in the far-flung village. In that case, we train parents or the caretakers of such children about the ways and methods to handle and treat so that they can follow and carry out easily at their homes. We personally visit them twice in a year.

While distributing the aids and assistance equipment we make sure that the equipment is well designed for the people with disability. No random distribution is done because the incorrect and improper aids can cause more damages. For e.g. a wheelchair for a child will be measured as per the requirement. 

At present we have a total of two centres operating in both Leh and Kargil district with a contribution of volunteers from all over the world.  The centre not only just work and concentrates on the people with disability but also provide psychosocial support and counselling services to the parents and caretakers. This proves quite beneficial and has a positive response because it is often witnessed that most of the cases parents are in stress and hardship.
 
The centres have the same timing as all the other schools. We provide pick and drop facilities and the children are divided into groups. Each group has 9 to 10 children and each group is treated in the centre twice or thrice in a week. The children share a very friendly environment with all the basic facilities and caretakers.

Q. What kind of activities do you provide them to improve the facilities for the children?

We provide physical therapy, occupational therapy, psychosocial service, special educator and also distribute aids and appliances.  A surgical intervention, admission of children to the school and house modification is also done.  With house modification, our effort is to make the children independent for the basic things in his/ her life. For e.g we make the toilet user-friendly for them. This year we have a plan to modify a total of five houses. 

We will organise a camp in collaboration with Social Welfare Department to make the children with disability avail basic schemes such as the distribution of disability certificate etc. From the awareness point of view, our student will participate in Ladakh Marathon.

The social welfare department is very supporting and co-operative; we are also planning and looking forward to work together in making the public places, schools etc. accessible to the people who face challenges in their day to day life.

Q. How physiotherapy help in overcoming these kinds of problems? Are there any specially trained physiotherapists in Leh?

We have well qualified and experienced people working with us.  Therapy is effective and results oriented if early intervention is done. It will definitely take time for the improvement as it is a very long procedure. 

A person or children who have been with the challenges for a long period of time have contractures and deformities which will be very hard to treat.

Q. Can you give us some examples of the success story of these children?

We have many case studies but if I talk about few encouraging story, a child name Angmo was unable to walk and has to be carried out by her parents.  We identified her and started giving therapy and counselling to her parents. She has been associated with us for 10 years. 
 
We admitted her in the school and made every possible effort to make her life easy and simple.  We took her to Germany twice for a surgery and have seen lots of improvement. 
 
A girl who can’t walk started walking with the help of crutches. With the help of regular therapy and support, she is pursuing her studies and can also drive modified scooter and four wheelers easily. 

Another story is about a boy named Thinley who has misdiagnosed Tuberculosis in the very childhood but later it was found that he has spinal cord injury. Because of the wrong treatment, the problem was exaggerated and was bed ridden.  Maximum of the daily activities of his life was carried out with the help second person.  With the help and support, today he walks easily with a help of a walker.  To make him independent economically he was given a capacity building course also by a specialised person from Germany. He learned art craft and started making products of handicrafts which we display and sell to the visitors who come to the centre. This way he earns independently.

Q. What kind of challenges and obstacles the specially abled people encounters in their day to day life. How do you help them in overcoming it?

Lack of inaccessible environment is the main challenges faced by them in their day to day life.   Unavailability of easy access facilities everywhere in our society makes their daily life hard and also demotivates their confidence level.  If I talk about the mindset of the people it has definitely changed with time and has gone way lot better but I feel that acceptance is still missing because we never felt the importance to make everything accessible to them because in schools, public places, govt. offices and every part of the society there is no accessible services and facilities.

The activities we provide is to make them overcome and we are further working on it.

Q. Do we have the basic facilities for their special needs to provide equal rights and opportunities for them in the society?

The basic facilities are missing everywhere. We heard that there are few schools in Leh who has rejected the admission of the specially abled student.  People are less aware and many couldn’t able to avail the benefits and schemes of the government.  Unfortunately, we don’t even have an exact data of the no. of disabilities in our region. 

In an old already established building, there can be issues to make the easily accessible facilities but in the new establishment and infrastructure such things should be preferred but unfortunately, in many of the cases it is missing. It is the responsibility of the concerned people who plans the new project to consider making the environment accessible to the people with the disability also.
 
Q. Talking about the facility and accessibility at all levels for the specially abled people many are left on paper with no implementation. Comment.

It is true we see hardly any implementation on the ground but I feel before any promises and words the prime importance is to have a strong policy describing every needs and facility.  Since 2012, we have demanded a land to establish a proper and equipped rehabilitation centre for the people with disability but till now, no response is there.

This year, the government has provided 10 Lakh under the disposal of Social Welfare Department for the people with disability. A meeting was called up with the NGO’s working for the disability and government officials also in which a discussion on the money disposal was carried out where we decide that the amount will be used for the survey on the total number of disability in Ladakh region to design activities and services. We have designed the format and the survey will be carried out this year.

Q. Do we have special schemes and assistance for specially abled people?

Yes, we have schemes but the accessibility is very hard and many are left without availing it.  The complex system has made the whole procedure very complicated.
 
Q. How important is it to have a special school and trained teachers for them in order to provide the equal and best education opportunity?  

The government talks about inclusion and in many states there are facilities and provision of Braille, sign languages but in Ladakh,  we are in short of these facilities thus the equal education opportunity is somehow neglected.

Q. How can we bring change and work towards the empowerment and upliftment of them in our society? 

Education is the most important things and is the strongest tool to make changes in the society towards the people with disability. Along with it exposure and experience are needed at the most to empower and uplift them.

Q. In Ladakh, we have three NGO’s working for a specially abled people, how do you coordinate with each other to empower them?

The three Ngo’s, Pagir, Rewa and Munsel are actively working for the people with disability of Ladakh region.  Frequently we meet and sit together to discuss the issues, plans and execution to carry out the work effectively and efficiently. We work collaboratively to help both the children and adult with the disability. In case of special education need for a child, we associate with Munsel likewise, the three organisation work in co-ordination. 

Q. What you have to say about people’s acceptance and support towards them? Do we still have the stigma attached to it in our society? 

In Ladakh, earlier people were more reluctant in opening up and accepting the people with special needs. Many families prefer to keep the child with disability behind the four walls because they feel humiliated. Many were left without help at the earliest because of less awareness and blind faith as it was often considered that a person suffers from disability because of karma. 

With time,  things started changing and because of awareness, fewer children are kept behind four walls. But acceptance is still very less because hardly anyone comes up to help and support them.  The thought to do something for the people is almost absent.

Message to the readers

We all need to walk together to uplift and empower the people with disability as they are also a part of our society.  They are a human and have the same feeling like us. Ensuring equal rights, facilities, and happy life is also our responsibility and duty. 


 
                   
 
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