mina*, 25, joined the Pakistan Society for Rehabilitation of Differently Able (PSRD) at the age of five. She came from a poor family and at the time suffered from a walking disability caused by polio. After an initial assessment of her financial situation, Amina was admitted to the school. The administration provided her with a free pickup and drop-off facility for all students, as per their policy. She graduated from high school a decade ago and completed basic computer training at the PSRD data center. Eventually, Amina was offered a job in a private sector company. Now married with a one-year-old boy, she lives well with her husband. She says she doesn’t want any publicity for herself. However, she wants the world to know her story to pay tribute to the institution that facilitated her rehabilitation and gave her the opportunity to excel in life. She says there are numerous cases of extremely poor and physically disabled people who support the PSRD well.
dr Numan Zakaria, the PSRD’s hospital administrator, says a physical disability can result from a birth defect, injury, or condition. It can also be due to exposure to viruses like polio. Mainly because of their limited mobility, people with disabilities often remain outside the economic mainstream, he says. “They can perform many tasks if their mobility is improved through surgery and physical therapy. They can also be trained professionally so that they do not become a burden on society but can contribute to the family income.”
This orthopedic hospital treats all patients without discrimination. Of the 1,920 surgeries performed between 2020 and 2021, 470 were serious; 387 medium; and 1.063 minor. There were 434 free operations, including 132 major operations. 1,438 operations were funded. Only two patients could afford the treatment and were charged the full cost.
The hospital’s physiotherapy center is well equipped with modern equipment. It is supervised by qualified physiotherapists. They offer the best treatment for patients and school children with various musculoskeletal and neurological impairments, trauma and other postoperative conditions. The center is available to all students of the PSRD school. Category E students receive free services.
The Orthotics and Prosthetics Center manufactured and delivered 3,630 appliances, including upper and lower limb prostheses, splints and orthoses, and orthopedic shoes. Silicone items, hyperextensions, and lumbosacral braces are also provided to patients.
Occupational and speech therapy play a key role in the rehabilitation of people with disabilities. School-based occupational therapy at the PSRD school involves therapists providing assessment and therapy in classrooms, and manufacturing orthotics and adaptive devices for the patients. An inclusive adaptive washroom provides toilet training for patients.
The students are assessed and checked by experienced speech therapists. The change of language session rooms is done according to the therapy protocols.
According to a recent World Bank report, around one billion people worldwide suffer from various disabilities. This accounts for almost 15 percent of the world’s population. The report states that people with disabilities are more likely to experience adverse socioeconomic outcomes such as less education, poorer health outcomes, lower employment rates and higher poverty rates. Poverty can 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 clean water and sanitation. Disability can also increase the risk of poverty due to the lack of employment and education opportunities, lower wages and higher cost of living with a disability.
The pride of the PSRD is its school. Children are raised to believe in themselves. The school provides free education, free books, transportation, uniform and food to all its students.
Disability statistics in Pakistan are grim. In the 1998 census, people with disabilities accounted for 2.49 percent of the total population. The sixth census in 2017 estimated that just 0.48 percent of the country’s population had a disability — far fewer than the 1998 census. How this decline in disability came about remains unclear.
The National Database and Registration Authority, based on its CNIC data, states that the number of people with disabilities in Pakistan is 371,833, including 31,914 with mental health problems. But if we calculate disability based on the 2017 census, the number of people with disabilities is around 1.1 million, which is almost three times the NADRA record. Some social work organizations claim that at least seven million people with disabilities (PWD) are forced to stay at home because they do not have access to wheelchairs in Pakistan. This number is even higher than the disability statistics from the 1998 census.
The PSRD is perhaps the only institution that offers a complete solution to the problems faced by a physically disabled person in a complex. It operates a 100-bed orthopedic hospital where specialists perform both minor and complex surgeries. After assessing their socioeconomic status, a patient is placed into one of five categories. Category A patients can afford to pay all fees, and category E patients receive free hospital treatment, free schooling (if the patient is a child), free physical therapy, free vocational training, and computer courses.
Madiha Maqsood, who is in charge of speech therapy at PSRD, gives the example of Mohammad, a three and a half year old who came to speech therapy. He was diagnosed with an expressive speech delay with echolalia. Since he was unable to express his wishes and needs verbally, intensive speech therapy was recommended to him. Two speech therapy sessions per week were designed. Vocabulary expansion techniques were used. Gradually he was able to use expressive language. Now he can form sentences and speak fluently. He can also follow complex commands and make requests and comments. Speech therapy has yielded 85 percent accurate results.
The PSRD has significantly transformed the lives of many less fortunate village women and children through community-based rehabilitation. CBR staff have been conducting regular surveys in several villages since 1993, raising awareness of cleanliness and medical rehabilitation, providing clinical physical therapy, coordinating case studies on their patients’ problems, and arranging wheelchairs or other aids for patients.
The PSRD has its own Vocational Rehabilitation Center which provides interest-free microloans to deserving adults with disabilities to start their own businesses. Loans totaling Rs 26.5 million have been disbursed to 965 people since the program began. The recovery rate was 98.64 percent.
Muhammad Murad, a 25-year-old resident of Mughalpura, Lahore, was physically disabled, needed a walker to get around and had to support four family members. He has faced this situation since birth. However, he was determined to do something for himself and not depend on anyone. He passed his intermediate exam and earned a diploma as a cell phone repair master. However, he was only earning Rs 10,000 per month, which was not enough to make ends meet.
Fortunately, he learned about the PSRD loan program and attended the vocational rehabilitation center to apply for a loan to open his own business. After the necessary documentation and verification, he was granted a loan of Rs 50,000. He is now earning around Rs 30,000 per month and is paying back the loan.
In addition to a state-of-the-art computer training center, the company also houses a competence development center and a vocational training center. They train the patients according to their individual abilities in order to introduce them to the economic mainstream.
The pride of the PSRD is its school. Children are taught to believe in themselves. The school provides free education, free books, transportation, uniform and food to all its students. The percentage of the school’s students who pass matriculation remains high. Last year the success rate was 94 percent. Recently, the PSRD established its College of Rehabilitation Sciences to create quality human resources for the rehabilitation of people with disabilities.
*Name has been changed to protect identity.
The author is a senior economics reporter