An Overview of Disability Situation in Nepal 1

An overview of disability situation in Nepal
AN OVERVIEW OF DISABILITY SITUATION IN NEPAL

A Term Paper
Submitted for the Partial Fulfillment of the Requirements of
Post Graduate Diploma in Counseling Psychology
Paper I
Submitted to:
PGD in Counseling Psychology Program
Tri-Chandra Multiple Campus
Faculty of Humanities and Social sciences
Tribhuvan University
Submitted by:
Jyoti Bohara
Roll no: 13
Exam roll no:
2013
AN OVERVIEW OF DISABILITY SITUATION IN NEPAL

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Paper I
Submitted by:
Jyoti Bohara
Approved:
.
Supervisor
.
Date of Approval
.
Program Coordinator
Date of Approval
Advisory Committee Member

.
Date of Approval

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ABSTRACT
This term paper entitled An Overview of Disability Situation in Nepal includes information
on disability situation of Nepal obtained from various secondary data sources. These days, the
term differently able as an alternative to disabled, handicapped etc has gained much
concern on the ground that it gave a more positive message. Disability means the restriction
or inability to perform an activity in the manner or within the range considered normal for a
human being. In Nepal, the definition of disability includes physical disability, visual
disability, hearing disability, speech disability, deaf blind, intellectual disability and multiple
disabilities. According to World Health Organization 10% of the people in any community
have disabilities. The main causes of disabilities are pointed out as war injuries, infectious
diseases, malnutrition, chronic diseases, substance abuse, accidents, violence etc. Various
literature reviews in Nepal showed that Nepal is still having issues on disabled people such as
stereotyped attitudes, stigma and discrimination, ignorance, teasing and bullying,
unemployment, lack of access to general and specialised services of education, treatment,
transportation etc. It ha been realised that promoting disabled peoples quality of life and
enhancing their equal participation in various developmental activities has become the urge
of todays world. This term paper also includes topics on various responses being taken by
government and stakeholders in the nation.

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TABLE OF CONTENTS
ABSTRACT
TABLE OF CONTENTS
Concept
Impairment
Disability
Handicapped
Objective of Study
Methodology
National Scenario on Disability
New Definition and Classification of Disability in Nepal
10
A. Classification of Disability based on nature of the problem
10
B. Classification of disability based on the degree of disability
12
Literature Reviews
13
Causes, Issues and Gaps
15
Causes
15
Issues of Disabled People in Nepal
15
Gaps in Addressing Disability in Nepal
17
Responses to Disability in Nepal
17
Attempts Being Made by Different Stakeholders for PWD in the Nation
17
Major laws and regulations concerned with Persons with Disabilities
18

5
Major laws and regulations concerned with Persons with Disabilities are The Interim
Constitution of Nepal 2006, Disabled Protection and Welfare Act 1982, Disabled Protection and
Welfare Regulation 1993, Education Act 1971, Special Education Policy 1996, Children Act
1992, Local Self-Governance Act 1999 and Labour Act 1999.
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Changing concept of Disability in Nepal
18
Conclusion
19
REFERENCES
20

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Concept
Disability is associated with impairment, handicap, and well-being of a person. A common
vision is that having a disability makes an individual less competent of performing a variety
of activities. Most people seem to know what a disabled person is and are certain that they
would be able to identify an individual as disabled, either because the disability is noticeable
or because they are aware of a specific medical condition that lends itself to be called
disability. Disabled people are capable to carry out various activities ranging from simple to
highly skilled, so, it is now more costmary to refer to such people as differently abled
rather than disabled.
Differently able was first proposed (in the 1980s) as an alternative to disabled, handicapped
etc on the ground that it gave a more positive message and so avoided discrimination towards
people with disabilities. The term has gained little currency, however, and has been criticized
as both over-euphemistic and condescending. The accepted term in general use is still
disabled.
General Definition on Disability

The WHO is one of the most important of the organisations that are continuously working on
a general definition of disability. Since 1980 the International Classification of Impairments,
Disabilities and Handicaps (ICIDH) has been the leading classification system regarding the
process of understanding and defining disability. It was reviewed in the late 1990s and led to
the setting up of the International Classification of Functioning, Disability and Health (ICF)
in 2002. The most commonly cited definition is that of the World Health Organisation in
1976, which draws a three-fold distinction between impairment, disability and handicap.

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Impairment: Technically, the term impair denotes damage or loss of physiological,

psychological or anatomical function or structure. This could mean loss of foot/ arm, poor
eyesight, hearing impairment, paralysis of limbs, defective vision.
Disability: As a result of impairment there is the restriction or lack of ability for an individual
to perform an activity in the manner or within the range considered normal for a human
being. A disability therefore describes a functional limitation. For example, being disabled
means having difficulty communicating (includes difficulty seeing, hearing and speaking),
having difficulty moving and having difficulty learning.
Handicapped: a handicap is a disadvantage in a persons life due to impairments or disability
as compared to other persons in performing the roles expected of him/ her in society, like not
being able to attend school or get a job or being socially isolated. Thus, a handicap is loss or
limitation of opportunities to take part in the life of the community on an equal level with
others.
There are three words frequently used in relation to Disability: Prevention, Rehabilitation
and Equalization of opportunities. Prevention means measures aimed at preventing the
onset of physical, sensory or mental impairments (primary prevention) or preventing the
progress of such impairment when it has occurred. Rehabilitation means goal oriented and
time-limited process aimed at enabling an impaired person to reach an optimum mental,
physical and/or social functional level involving early detection, diagnosis and intervention
(medical care and treatment), specialised education, training for self care, mobility,
vocational training, employment or marriage etc. Equalization of opportunities means the
process through which the social system in general such as the physical and cultural
environment , housing, transportation, social and health services , educational and work
opportunities , cultural and social life including supports , recreational facilities, marriage etc
are made accessible to all including the disabled.

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Objective of Study
The objective of study is to understand about disability situation in Nepal.
Methodology
For the completion of this term paper entitled, An Overview of Disability Situation in
Nepal various secondary data sources were reviewed from time and again. The secondary
data sources were made available through web archiving (journals, articles, research papers,
Wikipedias etc based on disability situation in Nepal).
National Scenario on Disability

In the present context, there is a compulsory need to accept the World Health Organization's
estimate in developing countries of the population of people with disability of 7-10 percent as
the basis in Nepal's context too. Around 15% of the worlds population or over a billion
people live with some form of disabilities. Furthermore, the rates of disability are increasing
in part due to ageing populations and an increase in chronic health conditions. 80 percent of
disabled people live in developing countries (WHO 2012).
Disability is present not only in Nepal but throughout the world, in all nations. It is either
congenital (from birth) or acquired due to accidents or as a result of disease. Irrespective of
any age group and races, it is found not only in human beings but also in animals. In fact,
disability is a human reality. Disability is even mentioned in mythology and religious books.
According to Hindu Mythology, The God Ganesh, son of Lord Shiva, is an ideal example of
disability and of corrective surgery.

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In the past, disability was taken as the punishment by god for some sin committed in the past
life. There are many families still that hide people with disabilities from society for the sake
of social prestige. Persons with disabilities are among the most deprived groups in Nepal,
historically excluded from the mainstream socio-politics and economic development. In
those days medical science was not sufficiently developed. So people accepted disability as
part of their fate and reconciled to live with it. Now, with advancement in science and
technology, many disabilities can either be minimized or cured. It has been observed that
approximately fifty percent of disabilities are preventable (Steward, 2001).
After the United Nations made a universal declaration on human rights in 1948, it is found to
have made similar declarations in Nepal to guarantee human rights for people with mental
disability in 1971 and for people with disability in 1975. In Nepal, education for the people
with blindness started from 2021 BS, for the hard of hearing from 2023 BS, and for people
with physical disability from 2026 BS. After the formation of the Special Education Council
in 2030, formed with the objective of development and expansion of special education,
activities for the education of people with disability started. At the time, activities like
formation of the then Social Council National Coordination Committee as well as various
activities in the area of development and upliftment of people with disability and helpless
people were initiated.
In 1981, a sample survey for disability was carried out first in Nepal in the course of
celebrating the international disability year. From this, statistics came to light that three
percent of people among the total population had disability. The directive principles of the
Constitution of Nepal, 2047 BS guarantee rights, benefits and protection of people with
disability, even as the Disabled Protection and Welfare Act, 2039 BS and Regulation, 2051

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have made various provisions for the development and interest protection of people with
disability.
New Definition and Classification of Disability in Nepal

Disability is the condition of difficulty in carrying out daily activities normally and in taking
part in social life due to problems in parts of the body and the physical system as well as
obstacles created by physical, social, cultural environment and by communication.
The National definition and classification on disability has been elaborated by Nepal
Government in September 2006 on the basis of International Classification of Functioning,
Disability and Health (ICF) and national context. The new definition comprises seven types
of disability: Physical disability, Visual Disability, Hearing Disability, Speech Disability, Deaf
blind, Intellectual Disability and Multiple Disabilities. The new definition has covered the
persons with muscular Dystrophy, little people, Autistic, deaf blind, stutters etc.
A. Classification of Disability based on nature of the problem:

According to the nature of the problem and difficulty in the parts of the body and in the
physical system, disability has been classified into the following seven categories:
1. Physical Disability: Physical disability is the problem that arises in operation of physical
parts, use and movement in a person due to problems in nerves, muscles and composition and
operation activities of bones and joints. For example: polio, cerebral palsy, absence of a body
part, effect of leprosy, muscular dystrophy, problem with joints and spinal chord, club feet,
rickets, weakness produced due to problem related to bones etc. are physical disability. Short
and stunted also fall into this category.

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2. Disability related to vision: It is the condition where there is no knowledge about an

object's figure, shape, form and colour in an individual due to problem with vision. It is of
two types:
Blind: A person who cannot see the fingers of hand by both eyes at a distance of 10 feet
despite treatment (medicine, surgery and use of glasses), or cannot read the first line of
Snellen chart (3/60), then that person is blind.
Low Vision: If any person who cannot distinguish fingers of a hand from a 20 feet distance
despite treatments like medicine, surgery and use of glasses, in other words, cannot read the
letters of the fourth line of Snellen chart, then that person has low vision.
3. Disability related to hearing: Problems arising in an individual related to discrimination of
composition of the parts of hearing and voice, rise and fall of position, and level and quality
of voice is a disability related to hearing. It is of two types:
Deaf: An individual, who cannot hear, speaks incoherently or cannot speak and who has to
use sign language for communication is deaf. An individual who cannot even hear sound
above 80 decibels is deaf.
Hard of Hearing: An individual who can hear only little but can hear little and cannot talk
clearly, can only speak little, who needs to put hearing aid in the ear to listen, is a hard of
hearing. An individual who can hear sound between 65 decibels and 80 decibels is a hard of
hearing.
Deaf-Blind: An individual who is without both hearing and vision is a deaf-blind disabled.
4. Deaf-Blind: An individual who is without both hearing and vision is a deaf-blind disabled.
5. Disability related to voice and speech: Due to difficulty produced in parts related to voice
and speech and difficulty in rise and fall of voice to speak, unclear speech, repetition of
words and letters is disability related to voice and speech.

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6. Mental Disability: The inability to behave in accordance with age and situation and delay
in intellectual learning due to problems arising in relation to implementation of intellectual
activities like problems arising in the brain and mental parts and awareness, orientation,
alertness, memory, language, calculation is mental disability.
Intellectual disability/Mental retardation: An individual having difficulty in carrying out
activities relative to age or environment due to absence of intellectual development before
age of 18 years is intellectual disability/mental retardation.
Mental illness: Mental disability is an inability where there is difficulty in living daily life
due to mental illness or weakness or deviation.
Autism: Absence by birth of normal behaviour in accordance with a person's age, to show
abnormal reaction, to keep on repeating one activity, to not socialize with others or to show
extreme reaction is autism.
7. Multiple disabilities: Multiple disabilities are problem of two or more than two types of
disability mentioned above.
B. Classification of disability based on the degree of disability

1. Complete disability: It is a condition where there is difficulty in carrying out daily
activities even with the continuous assistance of others.
2. Severe disability: It is a condition of having to continuously take other people's assistance
in order to carry out individual daily activities and to take part in social activities.
3. Moderate disability: It is a condition of being able to perform daily activities by self with
or without taking others' support, if the physical facilities are available, the physical
environment is removed and there are opportunities of training and education
4. Mild / Ordinary disability: It is a condition where taking part in regular daily activities and
social activities by self is possible if there is no social and environmental obstacle

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There is distribution of card system in Nepal in accordance to the degree of disability. The
Red card is given to complete disabled person. The Blue card is given to severely affect
disabled person. The Yellow card is given to moderately disabled person. The White card is
given to mild/ ordinary disabled person.
Literature Reviews
Different studies have reported different prevalence rate and the situation of disabilities in
Nepal. The WHO (1976) has estimated 7-10 % of prevalence rate in developing countries
such as Nepal. The study of Disability Situation Analysis (2001) conducted by NPC-UNICEF
has reported 1.63 % of prevalence rate of disability which comes to be the total of 371442
people with disability and various local district level studies indicated 3-5 % of prevalence
rate.
The condition of PWDs in Nepal is critical as reported in the study on The Disability
Situation Analysis (2001). Approximately 68.2 percentage PWDs have no access to
education at all; the lowest education status among all marginalised groups in Nepal.
Furthermore 85 percentage PWDs do not have access to health facilities in regards to their
impairment and disabilities while 77.8 percentages do not have any form of employment and
earning of their own. Participation of PWDs in community and organisation activities is
nominal. The lack of information reach has created misunderstanding of disability situation,
as well no proper references for planning and resources allocation and prioritisation of
various disability issues.
From 1971 various surveys have been conducted in Nepal to find out the prevalence
disability. The 1971 Census of Nepal estimated 1.5 percent of the total population over 10

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years of age having disabilities. The Disability Sample Survey of 1980 reported a prevalence
of about 3% disability among the total population while the national population census of
1981 stated only about 0.5% disability among the total population.
In an article titled The Disability Situation in Nepal by Meen Raj Panthi (2004), he has
explained about the existing problems faced by disabled people in Nepal. Nepali society still
views disability as a penance to the sins committed in previous births. The people with
disabilities pare treated worst as an object of pity. People with disabilities are hided as the
matter of social prestigious by families is still practiced largely. People with disabilities do
not have an equal rights and duty as any other individual. More over, still a large number of
the disabled persons have not got any kind of treatment. This could be due to lack of
knowledge and awareness that impairment can be treated. It could also be because the family
does not have the resources, or because the health facilities do not function properly and staff
does not know about disability.
Substantial change in the perception of Nepali society towards disabled persons took place in
1977 after the formation of the Social Service National Coordination Council that was headed
by Her Majesty Queen Aishwarya Rajya Laxmi Devi Shah. It was followed by several
important changes like establishment of the Ministry for Social Welfare, the enactment of
legislation for the Rights and Welfare of the Disabled, establishment of Social Welfare
Council etc. In Nepal, since 1992, every year December 3rd is celebrated as International
Day of the Disabled persons with various programmes like procession of disabled persons,
talk programmes, workshops, seminars etc. (Joshi, SK. 2004)

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Causes, Issues and Gaps

Causes
There are different causes for an individual to go through the pain of disability. The main
causes of disability in Nepal are War injuries, Accidents (including auto accidents, falls, near
drowning, burns, child abuse), Drug and toxic substance poisoning (including the use of
alcohol, caffeine, cigarettes etc), Genetic disorders (for example: down syndrome), High risk
conditions in women and infants (example: maternal epilepsy requiring certain drug therapy,
maternal diabetes, foetal deaths, maternal history of repeated abortion, infectious diseases
during pregnancy etc), Metabolic disorder (example: hypothyroidism), Malnutrition,
Intrauterine and other infectious diseases (Rubella, cytomegalovirus infection etc), Lack of
access to health care system and Low socio-economic conditions (this is because the poor
are more exposed to dangerous working and living conditions, including lack of access to
healthcare facilities, and poor nutrition in comparison to others.)
Issues of Disabled People in Nepal
People living with disabilities are facing different problems in each and every steps of their
life like: stereotyped attitudes about PWDs, stigma and discrimination, ignorance, teasing and
bullying, unemployment, lack of access to general and specialised services of education,
treatment, transportation etc.
When persons with a disability are kept from attending school or finding work, they tend to
be the poorest among the poor because they don't acquire any skills. Many people in
developing countries like Nepal think that children with disabilities can't learn or develop
skills, so not much is expected from them. In turn, they don't contribute to their communities

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but are considered to be a burden. The attitude of the parents, family members and the
community is that, there is no use of a disabled child being educated and it is a wastage of
time, money and other resources, as they think that a disabled child / adult is not productive
in any way.
There is the financial burden associated with getting health, education, and social services;
buying or renting equipment and devices; making accommodations to the home;
transportation; and medications and special food. There is still a condition where large
numbers of disabled are not getting medical treatments. This may be because of lack of
awareness on treatment process, family socio- economic conditions, and weakness of health
facility in not identifying disability.
Poverty is one of the causes of disability. On the other hand, disability can also be a cause of
poverty. When any one is socio-economically poor he/ she are exposed to dangerous working
and living conditions including lack of access to healthcare facilities, and poor nutrition in
comparison to others. When any one disabled in family and their caretakers do not have any
income generating sources then there is higher chance of becoming poverty. .They also has
fewer chances to overcome their disabilities. This increases the odds that they and their
families will remain poor.
The women with disabilities have been facing double discriminations first as a disabled
person and second as a woman. Though there is a provision of five years additional prison
sentence for the rapist of women with disabilities, the clause that grossly discriminates
between man with disability (MWD) and women with disabilities (WWD) is still active in
Muluki Ain, (2020 B.S.). The Marriage chapter, clause 9 of Muluki Ain permits husband to

17
remarry another woman if his wife get visual or locomotive impairment. The same is not
given to women. This is the case of double discrimination for being a woman and disabled
person.
Gaps in Addressing Disability in Nepal
Programmes and services to address the disability are very limited and they have been
focused specially in urban areas mainly. These initiatives are charity based and not from the
rights perspective. A study done by New Eras says, majority of people with disabilities are
out of education opportunity, health facility, accessibility, social security, aid and appliances,
vocational skills, income generating program, Community based Rehabilitation etc. Despite
recent efforts, from the media and self-help organizations, a large number of people with
disabilities are unaware about their rights. They still think disability as sin of their past life
and prefer to be the subject of pity and charity rather than to seek their rights to live a
respectable life in the society. Changes in the governing law have become charity outlook on
disability. Without ensuring rights to live a social life for the disable people through
legislation, the programmes designed for people with disabilities become futile. There seems
gap between the policies and their actual implementation. All the discriminatory provisions in
existing laws including the marriage clause of Muluki Ain should be eliminated.
Responses to Disability in Nepal

Attempts Being Made by Different Stakeholders for PWD in the Nation
Different attempts are being made by the Government at both central and local levels, NGOs
working on disability and INGOs/UN Agencies. They are Conducting Community Based
Rehabilitation (CBR) programmes. They are raising awareness and advocacy activities to
protect and promote the rights and opportunities of people with disabilities. They are also

18
providing preventive and corrective measures of disability in health sector. Various

scholarships and special education through integrated approach are being provided to
disabled. Vocational training and other income generating opportunities are being provided to
to support and promote livelihood of disabled. Among all introducing policies and laws for
protecting rights and opportunities of people with disabilities is highly appreciable.
Major laws and regulations concerned with Persons with Disabilities
Major laws and regulations concerned with Persons with Disabilities are The Interim
Constitution of Nepal 2006, Disabled Protection and Welfare Act 1982, Disabled Protection
and Welfare Regulation 1993, Education Act 1971, Special Education Policy 1996, Children
Act 1992, Local Self-Governance Act 1999 and Labour Act 1999.
Nepal ratified the UN Convention on the Rights of Persons with Disabilities in 2010. The
national legislation has not yet been aligned, but there have been some efforts to address the
rights of persons with disabilities, such as: Provisions in the new draft constitution protecting
the rights of persons with disabilities, the annual program adopted by the parliament for
2011/12, which includes specific provision for rehabilitation for persons with disabilities (as a
result of conflict), the national census carried out in July 2011 included more disability
specific questions in the main questionnaire category, Provision of disability ID cards which
gives holders certain privileges and allocation of small district budgets to disability programs
However, policies alone have not translated to concrete benefits for people due to lack of
awareness, advocacy and Government capacity to deliver its promise.
Changing Concept of Disability in Nepal

In the course of last 300 years, the concept of society towards disabled people has gradually
changed from neglect and hatred to charity based welfare work. The previous concept that
disabled persons should change according to their environment is no longer valid. The new

19
concept is that the environment should change in accordance with needs of disabled persons.
This is in line with the concept of equal opportunities for disabled person in society.
Through education and rehabilitation, person with different abilities have become more active
and have turned into a driving force in the future development of the disabled population. The
organisations (self-help organisations) of persons with disabilities and of their parents,
families and advocates have been formed to advocate better conditions for disabled persons.
It is now felt that the presence of large number of disabled persons is responsible for the
poverty in nation. These people cannot contribute effectively in developmental and economic
activities, thus leading to the poor economic growth of self and the nation. To promote their
quality of life and to enhance their equal participation in various developmental activities has
become the urge of todays world.
Conclusion
Disability is related to poverty and development. Enough information and documentation is
not available for developing countries like Nepal. Yet, there are lots of things to be done in
the field of disability. The environment should change in harmony with the needs of disabled
persons. Construction of ramps, escalators, conveyor belts etc. in the busy public places like
airports, bus stations, hospitals, hotels, government and private offices would significantly
ease their daily activities. The plan of action and programmes should be realistic and keeping
in mind the economic condition of the country and the capacity to implement programmes
and achieve results.

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REFERENCES
Thakur, S. C. (2010). A situation analysis of disability in Nepal. Tribhuvan University
Journal, Vol. 25, No.1. pp 1-9
Joshi, S.K. (2004). Disability in Nepal. Kathmandu University Medical Journal, Vol. 2, No.
1. pp 1-5
Disability- the WHO definition. (2002). Retrieved from http://www.making-prspinclusive.org/en/6-disability/61-what-is-disability/613-the-who-definition.html)
Differently abled. (September 13, 2009). Retrieved from
http://arnoldzwicky.wordpress.com/2009/09/13/labels/
WHO fact sheet on disability and health. (November 30 2012). Retrieved from
www.who.int/mediacentre/factsheets/fs352/en/index.html
National policy and plan of action on disability. (2006). Retrieved from
http://rcrdnepa.files.wordpress.com/2010/09/definition-and-classification-of-disability-innepal_english.pdf
Malla, U.N. (2008). Disability statistics in Nepal. Retrieved from
http://rcrdnepa.files.wordpress.com/2008/05/status-of-disability-related-statistic-innepal_uttam-narayan-malla.ppt
Disability. (2012). Retrieved from
http://web.worldbank.org/WBSITE/EXTERNAL/EXTABOUTUS/0,,contentMDK:23261965
~pagePK:51123644~piPK:329829~theSitePK:29708,00.html
Panthi, M.R. (2004). The disability situation in nepal - disability world. A bimonthly webzine of international disability news and views. Issue no. 24 June-August 2004. Retrieved
from http://www.disabilityworld.org/06-08_04/gov/nepal.shtml

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JICA. (2009). Country paper on disability in Nepal. Retrievd from

www.jicafriends.jp/vocational/pdf/v2009jobnepal0102.pdf
Save the children Norway/ Nepal. (2012 February). Mainstreaming disability in the new
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