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Local innovation and production ecosystem building in Nepal

OLDFREY, Ben
BAJRACHARYA, Amit Ratna
GURUNG, Ganga
LAL SHRESTHA, Pratisthil
CHANDRA THAPA, Ram
September 2023

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A series of short talks concerned with local innovation and production of AT devices in Nepal given by representatives of members of the associated ecosystem. A short history of the projects is presented. The devastating earthquake in 2015 and COVID both demonstrated the necessity for local innovation, production, repair and maintenance of AT. Three workstreams are ongoing: codesigning for individual needs; manual wheelchairs; and repair and spare part production. The need to develop local OT services in Nepal, particularly of bespoke provision, codesigning with the user to ensure achievable goals with a developed therapeutic intervention plan, is highlighted. Innovative AT associated with the knee joint and a diabetic foot and also a temperature monitoring device are shown and problems with local product validation are highlighted.  Ram Chandra Thapa (founder of Zener Technologies) describes the use of 3D printing in emergency engineering situations. He briefly describes his current project concerning wheelchairs, outlining associated difficulties, the local production ecosystem and the assessment of which parts are the most important for maintenance needs. The need for training and also finance to take a product from innovation to production are mentionned.

Persons with disabilities and climate change in Nepal: Humanitarian impacts and pathways for inclusive climate action

Jennifer M'Vouama, Humanity & Inclusion (HI)
Mosharraf Hossain, Team Leader, Global Inclusion Consulting Ltd
Sukharanjan Sutter, IRG Development Services Limited
Mahesh Ghimire, local consultant, Nepal
August 2023

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Climate change is affecting every region on Earth and already causing irreversible impacts. While it is a global phenomenon, its negative impacts are felt more intensely by poorer countries and poor communities heavily reliant on natural resources and lacking coping and adaptive capacities to deal with a changing climate. Within those poor communities and countries, persons with disabilities are often amongst the most marginalized people. They experience attitudinal, physical and communication barriers that undermine their access to services and opportunities supporting their well-being and resilience. For this reason, they tend to be disproportionately vulnerable to climate impacts, including more frequent and intense disasters, as those exacerbate pre-existing vulnerabilities. Yet, while it is acknowledged that climate change will exacerbate inequity should we fail to ensure inclusive and participatory decision-making processes in climate governance, disability inclusion in climate action largely remains marginally addressed. Persons with disabilities have been historically left out of climate responses at various levels, from local and national country plans to global negotiations occurring at the UN Conferences of the Parties1 (COP).


Nepal is experiencing an increasing number of climate-related disasters, with a global study ranking it as the fourth worst hit country in the world by weather-related loss events in 20172. Urban floods, landslides, extreme heat, storms, drought, and wildfires are very common climate disasters affecting communities across the country, especially rural populations and their natural resource-dependent livelihoods. Nepal’s vulnerability to climate change lies in its varied topography marked by steep terrain and remoteness, its diverse geo-climatic system and social vulnerability, exacerbated by challenges to deliver effective and comprehensive disaster risk reduction and management strategies. To address this serious threat to economic development and prosperity, Nepal has put in place a rich overarching climate change policy framework early on, encompassing dedicated policies and plans, as well as sectoral planning processes integrating climate resilience. Nepal has also established various leadership, coordination, and stakeholder engagement mechanisms to guide climate change policymaking, articulate implementation across the government’s three-tier federal structure, and ensure dialogue with key stakeholders including civil society actors.

Endorsed in 2011, Nepal’s Framework on Local Adaptation Plans for Action (LAPA) is a particularly praised initiative, promoting a bottom-up, inclusive, and flexible approach for integrating climate adaptation and resilience aspects into local planning. This pioneering, community driven process, places the adaptation needs and opportunities of most vulnerable and highly vulnerable groups at the heart of the approach. Gender considerations factoring intersecting factors of marginalization such as age and ethnicity have been given priority in these processes, to address women’s increasing economic insecurity and workload due to climate change. But inclusion of women with disabilities, or persons with disabilities in general in local adaptation planning has not been strongly evidenced to date.


According to Nepal Census 2022, 2.2% of the Nepali Population have some form of disability, mainly a physical disability. However, other sources estimate this figure to be much higher. Nepal ratified the United Nations Convention on the Rights of Persons with Disabilities (CRPD) in 2008 and passed the Disability Rights Act in 2017, establishing constitutional directives to support persons with disabilities and making it illegal to discriminate based on disability. Yet, perception of persons with disability in Nepal remains generally negative, due to persistent and deep-rooted Hindu religious beliefs associating disability with sinning in a previous life. Women and girls with disability face greater marginalization and discrimination and tend to be hidden away by families. Nepal’s caste system also plays a role in shaping the vulnerability of persons with disabilities. Thus, widespread stigma compounded by the intersectionality of certain factors, combined with structural inaccessibility, create significant barriers to have equal access to resources and participate in decision-making. This tends to translate into poor socio-economic status, poor health outcomes, and no or low education levels, especially among women and girls. Persons with disabilities in Nepal can register under social welfare to access several disability-targeted benefit packages, including a Disability Grant. However, the process tends to be paved with barriers, leading to high exclusion rates.
It is in this context that HI sought to better understand the unique challenges and opportunities for persons with disabilities in the face of climate change in Nepal. This report is intended to inform how persons with disabilities understand and perceive climate change, what is their experience of dealing with climate extremes, what is the impact on their health, livelihoods and support system, and their actual level of inclusion in climate adaptation planning. To capture those perspectives, HI surveyed 388 persons with disabilities across Nepal’s 7 provinces, consulted 20 key informants from the disability movement, government institutions, and the aid sector, and conducted 8 targeted focus group discussions to hear from women, youth, and persons representing diverse disability types. This report is a contribution to the growing evidence base documenting the disproportionate impacts of climate change on persons with disabilities and calling for disability-inclusive climate action at all levels of governance.

Strengthening rehabilitation in health emergency preparedness, readiness, response and resilience: policy brief

Pete Skelton
et al
July 2023

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Strengthening rehabilitation in health emergency preparedness, response, and resilience: policy brief outlines the evidence for rehabilitation in emergencies and the need for greater preparedness of rehabilitation services. It shows how existing guidelines support the integration of rehabilitation in emergencies and sets out the steps that decision-makers can take to better integrate rehabilitation into health emergency preparedness and response.

Case studies are provided from Japan, Nepal, Phillipines, Australian and Sweden

Beyond visibility: A learning Brief on Vulnerability Focal Point Approach

Humanity and Inclusion
January 2023

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This fact sheet presents the main lessons learned and the factors that helped and hindered the use of the intervention called the Vulnerability Focal Point (VFP) approach to improve access to and use of SRH services by people with disabilities.

The lessons learned from the VFP approach provide a reflection on what has worked and what has not. In addition, this note recommends ways to further improve the approach based on the experience and reflections of key stakeholders, including project beneficiaries (people with disabilities in the selected sites), VFPs, respective local government representatives, Humanity & Inclusion (HI) and its partners, and donors. The lessons learned will be crucial for making informed decisions about the continuation, scaling up, replication and sustainability of the VFP approach in the future.

Are persons with disabilities included in the effort to leave no-one behind? Mapping disability data in development in Asia and the Pacific

CBM GLOBAL’S INCLUSION ADVISORY GROUP
February 2022

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In the Asia Pacific region, UNFPA and partners work together to implement the Incheon Strategy to “Make the Right Real” for Persons with Disabilities. The Incheon Strategy is the region’s first set of disability-specific development goals to track progress towards the fulfilment of rights of persons with disabilities.

In the region, it is estimated that there are over 650 million persons with disabilities. However, without accurate, timely and disaggregated data, countries are unable to develop effective policies and programmes, monitor the wellbeing of persons with disabilities and evaluate the equity and impact of development efforts. This endangers country commitments to ‘leave no one behind’ and undermines their obligations to the Convention on the Rights of Persons with Disabilities.

This groundbreaking report demonstrates the importance of ensuring data is inclusive and provides recommendations for immediate action in order to improve the collection, analysis and reporting of disability data

Lives turned upside down in COVID-19 times: exploring disabled people's experiences in 5 low-and-middle income countries using narrative interviews

WICKENDEN, Mary
SHAW, Jackie
THOMPSON, Stephen
ROHWERDER, Brigitte
2021

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This article explores COVID-19 related experiences of disabled people in Bangladesh, Kenya, Nigeria, Nepal and Uganda. Narrative interviews generated storied responses, focussing on respondents' priorities, which enabled us to hear what was most significant for them and their families. 143 interviews were conducted online or by phone by 7 local researchers (3 disabled), with appropriate inclusive support. Nearly everyone was interviewed twice to capture the progression of impacts over time. The data was analysed thematically through a virtual participatory approach. An overarching 'subjective' theme of feelings experienced by the participants was labelled 'destabilisation, disorientation and uncertainty'. We also identified 'concrete' or material impacts. People experienced various dilemmas such as choosing between securing food and keeping safe, and tensions between receiving support and feeling increased vulnerability or dependence, with interplay between the emotions of fear, loss and hope. We found both the concept of liminality and grief models productive in understanding the progression of participants' experiences. Disabled people reported the same feelings, difficulties and impacts as others, reported in other literature, but often their pre-existing disadvantages have been exacerbated by the pandemic, including poverty, gender and impairment related stresses and discrimination, inaccessible services or relief, and exclusion from government initiatives.

A disability inclusive response to COVID-19 - four lessons learned about including people with disabilities in humanitarian aid

MORRIS, Lisa
ELLIOTT, Chris
PIERI, Susan
September 2021

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Inclusive Futures played a crucial role in supporting some of the most marginalised people with disabilities in Bangladesh, Kenya, Nepal, Nigeria, and Tanzania during the COVID-19 pandemic. This paper summarises what we learned and it can be used to include people with disabilities in future programming, particularly in contexts at risk of crisis.

Taking a Disability-Inclusive Approach to Pandemic Responses

WICKENDEN, Mary
THOMPSON, Stephen
ROHWERDER, Brigitte
SHAW, Jackie
2021

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The Covid-19 pandemic has affected communities globally, yet the impact has not been equal. People with disabilities were already often living with severe disadvantage and marginalisation and, as predicted by many disability-focused agencies, Covid-19 has exacerbated these inequalities. Emerging evidence from Inclusive Futures, a UK Foreign, Commonwealth & Development Office (FCDO)-funded programme, highlights the catastrophic emotional and material impacts on people with disabilities in Nepal and Bangladesh. To respond to and plan for future crises, decision makers should consult inclusively with both organisations of people with disabilities (OPDs) and people with disabilities themselves.
 

‘Because of COVID, Everything is a Mess’ How Have People with Disabilities Experienced the Pandemic in Nepal and Bangladesh?

ROHWERDER, Brigitte
THOMPSON, Stephen
SHAW, Jackie
WICKENDEN, Mary
KAYASTHA, Shubha
SIGDEL, Anita
AKTER, Fatema
BOSRI, Rabia
March 2021

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COVID-19 is deepening pre-existing inequalities. Emerging research suggests that people with disabilities across the world have experienced various rights violations and been disproportionality affected by the health, economic and social impacts of the pandemic and responses to it. The aim of this research was to better understand how people with disabilities who are often excluded from research have experienced the evolving COVID-19 pandemic in Bangladesh and Nepal. In order to better understand how it has affected some of the most marginalised groups of people with disabilities, this study used in-depth qualitative research to focus on people with intellectual, psychosocial, deafblindness and other multiple impairments.

 

আমরা বাংলাদেশে (20 জন লোক) এবং নেপালে (15 জন লোক) বসবাসরত 35টি ডিজেবলড লোকদেরকে কোভিড-19 প্রাদুর্ভাব চলাকালীন সময়ে তাদের জীবন সম্পর্কে জিজ্ঞাসা করেছি। তাদের মধ্যে বধিরতা, নেত্রহীনতা, বৌদ্ধিক ডিজেবিলিটি এবং মানসিক ডিজেবিলিটি’র মতন বিভিন্ন ধরণের ডিজেবিলিটি রয়েছে। তাদেরকে জিজ্ঞাসা করার প্রধান কারণ হল যে প্রায়শই তাদেরকে তাদের জীবন সম্পর্কে কিছুই জিজ্ঞাসা করা হয় না। আমরা ডিজেবলড বাচ্চাদের বাবা-মাদেরকেও তাদের অভিজ্ঞতা সম্পর্কে জিজ্ঞাসা করেছি।

 

हामीले बङ्गलादेश (20 जना मानिस) र नेपाल (15 जना मानिस) मा अपाङ्गता भएका 35 जना व्यक्तिलाई कोभिड-19 को प्रकोपको समयमा आफ्नो जीवन बारे हामीलाई बताउन अनुरोध गर्‍यौं। उहाँहरूलाई वणदृष्टिविहीन, बौद्धिक अपाङ्गता र मनोसामाजिक अपाङ्गता जस्ता विभिन्न अपाङ्गता थिए। उहाँहरूलाई प्रायः आफ्नो जीवन बारे नसोधिने भएकोले हामी उहाँहरूलाई सोध्न चाहन्थ्यौं। हामीले अपाङ्गता भएका बालबालिकाका आमाबुवाहरूलाई पनि सोध्यौं।

COVID-19 in South Asia: State practices, responses and the experiences of persons with disability within the region

MEHROTRA, Nilika
SOLDATIC, Karen
2021

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An introduction into South Asia looking at the pandemic who people are struggling with in 2020. The DGS has aimed to first identify and acknowledge the diversity of disability experiences in the Global South and, second, make these experiences readily available and accessible to disabled people and their communities in the regions where the contributors themselves are from. In fact, in undertaking this special issue as editors, we would like to recognize the incredible persistence of our contributors to continue to work with us throughout the development of the papers, alongside acknowledging the many original contributors who were also unable to accept our invitation to participate because of the covid19 pandemic impacts upon every aspect of their lives.

COVID 19 in Nepal: The Impact on Indigenous Peoples and Persons with Disabilities

GURUNG, Pratima
2021

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The COVID 19 pandemic crisis is unfolding against the backdrop of several important milestones for equality and the human rights of various marginalized groups including women and girls, indigenous peoples and persons with disabilities in all their diversities and intersections in Nepal. The COVID-19 pandemic has entrenched systemic gaps, underlying structural inequalities and pervasive discrimination, more visible with inadequate healthcare, access to information, employment and livelihoods, and social protection system mainly for marginalized groups. This study aims to understand the challenges and impacts of the COVID 19 on marginalized groups including persons with disabilities in Nepal. Based on qualitative research with primary and secondary information, the paper emphasizes the experiences and realities of marginalized groups during the lockdown and pandemic situations. Some of the existing challenges faced by marginalized groups include access to information and health measures related to COVID 19, access to livelihoods and employment, increasing rates of suicide, violence against women from marginalized groups, women with disabilities, and others. The study will integrate these components and deal with intersections with concrete recommendations. 

A glimpse into smartphone screen reader use among blind teenagers in rural Nepal

SANKHI, Prakash
SANDNES, Frode Eika
2020

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Purpose

Access to appropriate assistive technology is a challenge worldwide and especially in low GDP-per-capita countries. Nepal is one example of a country with several coinciding challenges: some claim having a high rate of blindness in the general population, a low-GDP-per capita and some studies claim it has a low literacy rate, especially in rural areas. Without appropriate assistive technology, some disabled youth may not get full access to education.

 

Methods

To gain insight into assistive technology use in rural Nepal, five blind teenagers in a mixed secondary school with disabled and non-disabled students in rural Nepal were interviewed about their daily smartphone use.

 

Results

The results show that all the participants used screen readers on donated smartphones. None of the participants had received formal training in using smartphone screen readers and therefore lacked knowledge about basic and essential operational aspects of the devices as well as misguided expectations about the technology.

 

Conclusions

One implication of the findings is that smartphone accessibility features training material needs to be made easily available to schools and all disabled youth worldwide, as smartphones are increasingly becoming available in low-income remote regions with low literacy rates. The built-in accessibility features of smartphones promise disabled youth a non-stigmatizing platform for social participation and access to the information society.

Disability Inclusive Development - Nepal Situational Analysis

ROHWERDER, Brigitte
June 2020

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This situational analysis (SITAN) addresses the question: “what is the current situation for persons with disabilities in Nepal?”. It has been prepared for the Disability Inclusive Development programme (which works on access to education, jobs, healthcare, and reduced stigma and discrimination for persons with disabilities in Bangladesh, Jordan, Kenya, Nepal, Nigeria, and Tanzania), to better understand the current context, including COVID-19, and available evidence in Nepal. It will be helpful for anyone interested in disability inclusion in Nepal, especially in relation to stigma, employment, education, health, and humanitarian issues. This SITAN has been briefly updated from the April 2019 SITAN.

Access to age-assistive technology: A resilience building measure for older people

HISCOCK, Diana
MALIK, Deepak
June 2020

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The intersection between age, gender and disability and the use of assistive technology (AT) by older people, in emergency response and as a tool for disaster risk reduction (DRR) is explored. The report shows that AT can have a positive impact on independence, vulnerability reduction and resilience building for older women and men in humanitarian crises. This report urges for sensitization and capacity building of humanitarian organizations for the inclusion and promotion of assistive product (AP) provision in humanitarian response and offers insight into key areas to enable AT provision to successfully meet the needs of older people.

 

The study employed primary research methods to gather both quantitative and qualitative information through a semi-structured survey with HelpAge programme beneficiaries in five countries: Bangladesh, Indonesia, Myanmar, Nepal and Pakistan. The survey incorporated the Washington Group short set of questions (WGQs), designed to identify people with functional difficulties in six core functional domains: mobility, vision, hearing, cognition, self-care and communication (Washington Group on Disability Statistics, 2016). The report also summarises secondary research including a literature review, information from rapid needs assessments carried out by HelpAge, and maps out relevant policy changes which have led to better recognition of the intersectionality and importance of AT for older men and women.

Association of anxiety and depression with physical and sensory functional difficulties in adults in five population-based surveys in low and middle-income countries

WALLACE, Sarah
MACTAGGART, Islay
MORGON BANKS, Lena
POLACK, Sarah
KUPER, Hannah
June 2020

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The aim of this study was to assess the association between anxiety and depression with physical and sensory functional difficulties, among adults living in five low and middle-income countries (LMICs).

A secondary data analysis was undertaken using population-based disability survey data from five LMICs, including two national surveys (Guatemala, Maldives) and 3 regional/district surveys (Nepal, India, Cameroon). 19,337 participants were sampled in total (range 1,617–7,604 in individual studies). Anxiety, depression, and physical and sensory functional difficulties were assessed using the Washington Group Extended Question Set on Functioning. Age-sex adjusted logistic regression analyses were undertaken to assess the association of anxiety and depression with hearing, visual or mobility functional difficulties.

The findings demonstrated an increased adjusted odds of severe depression and severe anxiety among adults with mobility, hearing and visual functional difficulties in all settings (with ORs ranging from 2.0 to 14.2) except for in relation to hearing loss in India, the Maldives and Cameroon, where no clear association was found. For all settings and types of functional difficulties, there was a stronger association with severe anxiety and depression than with moderate. Both India and Cameroon had higher reported prevalences of physical and sensory functional difficulties compared with Nepal and Guatemala, and weaker associations with anxiety and depression

Voices of people with disabilities during the COVID19 outbreak

INTERNATIONAL DISABILITY ALLIANCE (IDA)
May 2020

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A collection of stories from people with various disabilities across the globe sharing their experiences with the COVID-19 outbreak and pandemic risk reduction strategies implemented by their governments. Some stories are written by IDA and some are external.

Examples are:

  • How absence of transport can be fatal: A Story from Uganda
  • In Uganda, a Deaf man loses his leg after being shot during curfew
  • Voices of Mexico: Disability and COVID-19 | Voces de Mexico: Discapacidad y COVID-19
  • COVID-19 in Mexico: the experience of deafblind children told by their mothers (Espanōl)
  • Reaching Persons with Deafblindness
  • COVID-19 and The Forgotten People (Indonesia)
  • When accessible information is far from a reality: Zimbabwe during COVID-19
  • The experience of a blind woman in Kenya under COVID-19 outbreak
  • Being a single mother of two persons with disabilities under COVID-19 (South Africa)
  • Autistic students in South Africa: how has their life changed?
  • The Story of Rose Rokiatou: COVID-19 Pandemic and Financial Vulnerability of Persons with Disability in Mali
  • COVID-19 in Romania: Life-threatening situations reported
  • COVID-19 in Nepal: What are the challenges for indigenous persons with disabilities?
  • COVID-19 in India : Technology can be your best friend or worst enemy

Inclusion of persons with disabilities in humanitarian action. Case studies collection 2019. 39 examples of field practices, and learnings from 20 countries, for all phases of humanitarian response

PALMER, Tom
et al
December 2019

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Published at the same time as the Inter-Agency Standing Committee (IASC) Guidelines on Inclusion of Persons with Disabilities in Humanitarian Action, this report aims to support their uptake and promote learning by example. This report presents 39 short case studies on inclusive practices for persons with disabilities in humanitarian action and disaster risk reduction (DRR). It is designed for humanitarian stakeholders with limited experience of working with and for persons with disabilities, as well as for organizations of persons with disabilities (OPDs) planning to engage in humanitarian action and DRR. The report draws lessons from field practices, but does not provide technical guidance. The IASC Guidelines are the reference document to seek in-depth theoretical and technical information

 

The case studies focus on:

  • Inclusive disaster risk reduction and preparedness
  • Collecting and using disability disaggregated data for assessments and programming.
  • Participation of persons with disabilities and their representative organizations in humanitarian response and recovery
  • Removing barriers to access humanitarian assistance and protection.
  • Influencing coordination mechanisms and resource mobilization to be inclusive

 

The evidence presented in this report was identified in 2017-2018 through a desk review of publicly available reports and internal documents on projects implemented by CBM, HI and IDA members, as well as their partners and affiliate members. Field visits to Lebanon, Jordan, Kenya, Nepal, and the Philippines conducted in 2018 also informed the case-study collection and documentation

Gaps in access and school attainments among people with and without disabilities: a case from Nepal

EIDE, Arne
LAMICHHANE, Kamal
NEUPANE, Shailes
November 2019

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Determinants of school achievement in Nepal among persons with and without disabilities as well as among each type of impairment were determined using data from a nationally representative disability inclusive survey collected in 2015.  The individual level data used in this article comprise 2123 persons with and 2000 persons without disabilities.

 

Disability and Rehabilitation

https://doi.org/10.1080/09638288.2019.1691272

 

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