mina*, 25, came to the Pakistan Society for Rehabilitation of Differently Abled (PSRD) at the age of five. She belonged to a poor family and was at that time suffering from a walking disability due to polio. After an initial assessment of her financial situation, Amina was admitted to the school. The administration provided her with a free pick-and-drop facility, as per their policy for all students. She passed high school a decade ago and completed basic computer training at the PSRD computer centre. Amina was eventually offered a job in a private sector firm. Now married, with a one-year-old boy, she is living comfortably with her husband. She says she doesn’t want publicity for herself. However, she wants the world to know her story to pay tribute to the institution that facilitated her rehabilitation and provided her with an opportunity to excel in life. She says there are numerous cases of extremely poor and physically disabled individuals doing well help from the PSRD.

Dr Numan Zakaria, the hospital administrator at the PSRD, says that physical disability can result from a birth defect, injury or ailment. It can also be on account of exposure to viruses like polio. He says differently abled people frequently remain out of the economic mainstream mainly because of their restricted mobility. “They can perform many duties if their mobility is improved through surgery and physiotherapy. They can also be given vocational training so that instead of becoming a burden on the society, they can contribute their bit to the family income.”

This orthopaedic hospital treats all patients without any discrimination. Out of the 1,920 surgeries carried out in 2020-21, 470 were major; 387 medium; and 1,063 minor. There were 434 free surgeries, including 132 major surgeries. 1,438 surgeries were subsidised. Only two patients could afford and were charged the full cost of the treatment.

The physiotherapy centre of the hospital is well equipped with modern gadgets. It is manned by qualified physiotherapists. They provide the best treatment to patients and school children with different musculoskeletal, and neurological impairments, trauma injuries and other post-operative conditions. The centre is available to all students of the PSRD school. Students in the E category are provided free services.

The orthotics and prosthetics centre manufactured and delivered 3,630 appliances including upper and lower limb prosthetics, splints and braces and orthopaedic shoes. Silicon items, hyperextensions and lumbosacral corsets are also provided to the patients.

Occupational and speech therapy play a key role in the rehabilitation of the differently-abled. The school-based occupational therapy at the PSRD school involves therapists that provide assessment and therapy in classrooms, producing orthosis and adaptive equipment for the patients. An inclusive adaptive washroom provides toilet training to the patients.

Assessment and screening of the students is done by expert speech therapists. Modification of speech session rooms is undertaken as per therapy protocols.

According to a recent World Bank report, about one billion people worldwide are suffering from different disabilities. This accounts for almost 15 percent of the global population. The report says that persons with disabilities are more likely to experience adverse socioeconomic outcomes such as less education, poorer health outcomes, lower levels of employment and higher poverty rates. Poverty may increase the risk of disability through malnutrition, inadequate access to education and health care, unsafe working conditions, a polluted environment, and lack of access to safe water and sanitation. Disability can also increase the risk of poverty, through lack of employment and education opportunities, lower wages and increased cost of living with a disability.

The pride of the PSRD is its school. The children are educated to believe in themselves. The school provides free education, free books, transport, uniform and nutrition to all its students. 

Disability statistics in Pakistan are murky. In the population census held in 1998, persons with disabilities were recorded as 2.49 per cent of the total population. The sixth population census held in 2017 estimated that only 0.48 per cent of the population in the country was disabled – far less than the 1998 census. How this decrease in disability came about remains unexplained.

The National Database and Registration Authority, on the basis of its CNIC data, states that the number of people with disabilities in Pakistan is 371,833 including 31,914 with mental challenges. But if we calculate disability based on the 2017 census the number of differently abled people comes to around 1.1 million which is almost three times higher than the NADRA record. Some social work institutions claim that at least seven million people with disabilities (PWD) are forced to stay home as they do not have access to wheelchairs in Pakistan. This figure is higher than even the 1998 census disability statistics.

The PSRD is perhaps the only institution that provides a complete solution to the problems faced by a physically handicapped individual in one compound. It runs a hundred-bed orthopaedic hospital where specialist doctors perform minor as well as complicated surgeries. After assessment of their socio-economic status, a patient is classified in one of five categories. Category A patients can afford to pay all charges and Category E get free treatment at the hospital, free schooling (if the patient is a child), free physiotherapy, free vocational training and computer courses.

Madiha Maqsood, incharge of speech therapy at the PSRD cites the example of Mohammad, a three-and-a-half-year old who came for speech therapy. He was diagnosed with an expressive language delay with echolalia. Intensive speech therapy was recommended for him as he was unable to express his desires and needs through language. Two speech therapy sessions per week were designed. Vocabulary-enhancing techniques were used. Gradually he was able to use expressive language. Now he is able to make sentences and speak fluently. He can also follow complex commands and make requests and comments. The speech therapy has had 85 percent accurate results.

The PSRD has brought a meaningful change in the lives of many less fortunate village women and children through community-based rehabilitation. The CBR staff, since 1993, regularly conducts surveys in several villages, creating awareness about cleanliness and medical rehabilitation, providing clinical physiotherapy, coordinating case studies of the problems of their patients and arranging wheelchairs or other devices for the patients.

The PSRD has its own vocational rehabilitation centre, which provides interest-free micro loans to deserving adults with disabilities to start their own businesses. Since the commencement of the scheme, Rs 26.5 million loans have been disbursed to 965 individuals. The recovery rate has been 98.64 percent.

Muhammad Murad, a 25 years old resident of Mughalpura, Lahore, was physically disabled, needed a walker to move around and had to support four family members. He had faced this situation since he was born. However, he was determined to do something for himself and not become dependent on anyone. He passed his intermediate exams and obtained a diploma in mobile phone repair. However, he was only making Rs 10,000 per month which was not sufficient to make ends meet.

Fortunately, he came to know about the PSRD loan scheme and visited their Vocational Rehabilitation Centre to apply for a loan to open his own shop. After necessary documentation and verification, he was provided a Rs 50,000 loan. He is now earning approximately Rs 30,000 per month and repaying the loan.

The Society also houses a Skill Development Centre and a Vocational Training Centre, besides a state-of-the-art Computer Training Centre. These train the patients according to their individual capabilities to induct them into the economic mainstream.

The pride of the PSRD is its school. The children are taught to believe in themselves. The school provides free education, free books, transport, uniform and nutrition to all its students. Passing percentage of the school’s students in matriculation remains high. Last year the pass percentage was 94 percent. Lately, the PSRD has started its College of Rehabilitation Sciences to produce quality human resource for the rehabilitation of the differently abled.

*Name has been changed to protect identity.

The writer is a senior economic reporter