Development efforts in Afghanistan: is there a will and a way ?


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This collective work addresses key issues surrounding the provision of international assistance. It is based on fieldwork and research undertaken in Afghanistan, and evaluates a number of development programmes. By identifying the gap between the needs of people and the delivery of aid, and examining the decision making processes of donnor agencies in determining which programmes to fund, this book questions the underlying values and assumptions that motivate interventions.



Publié par
Date de parution 01 juillet 2011
Nombre de lectures 32
EAN13 9782296463790
Langue Français
Poids de l'ouvrage 6 Mo

Informations légales : prix de location à la page 0,0005€. Cette information est donnée uniquement à titre indicatif conformément à la législation en vigueur.

Signaler un problème
The case of disability and vulnerability
Ethique Economique Collection dirigée par François Régis Mahieu
L’éthique rejoint l’économie dans la recherche du bonheur pour soi et pour les autres. Lindividu nest pas totalement opportuniste, il concilieégoïsme et altruisme. Reconnaître les formes de léthique est une prioritéen évertu, responsabilitconomie : é, discussion, justice. Une attention particulière est accordéeàléthique du développement, en particulieràla considération accordéeàla justice intra et intergénérationnelle dans le cadre du développement durable. Léthique se traduit par desévaluations et des sanctions vis-à-vis de ceux qui ont la responsabilitéde lavie bonne. Cette collection concilie recherche et pédagogie, réflexion et action, dans loptique la plus large possible.
Déjà parus
Arnaud MAIGRE,De léthique en économie, 2010. Ali TOUSSI,Le taux d'intérêt dans un système financier islamique, 2010. Ali TOUSSI,La banque dans un système financier islamique, 2010. Jean CARTIER-BRESSON,Economie politique de la corruption et de la gouvernance, 2008. Réseau IMPACT,Repenser laction collective. Une approche par les capabilités, 2008. Laurent PARROT (coord.),Agricultures et développement urbain en Afrique subsaharienne. Gouvernance et approvisionnement des villes, 2008. Laurent PARROT (coord.),Agricultures et développement urbain en Afrique subsaharienne. Environnement et enjeuxsanitaires, 2008. Samir ZEMMOUR,Vers une certification de qualité halal ?, 2007. Samir ZEMMOUR,Le marché de la viande Halal : évolutions, enjeux et perspectives,2006. Jérôme BALLET, Katia RADJA,Le capital social en action, 2005. J. BALLET, J.-L. DUBOIS, F.-R. MAHIEU,Lautre développement, 2005.
Jean-Francois Trani (Ed.)
The case of disability and vulnerability
© L'HARMATTAN, 2011 5-7, rue de l'École-Polytechnique ; 75005 Paris
ISBN : 978-2-296-54522-9 EAN : 9782296545229
Foreword Jean-Luc Dubois and Francois-Regis Mahieu Afghanistan is still in a situation of conflict. This is a sad but undeniable reality. The said conflict continues to generate thousands of wounded and distressed Afghans thus increasing the number of people with disabilities and mental problems. War survivors are not the only victims of the on going conflict. Many others vulnerable groups are facing some form of disability that leads to their exclusion from society. These are poor, uneducated or unemployed people, isolated women with children and the elderly. Moreover people with other forms of impairment such as congenital diseases, chronic conditions, victims of accidents also face difficult circumstances. This book shows that war alongside poverty or social disadvantage leads to problems such as low self-esteem, loss of meaning of life and deterioration of social networks and sometimes even marginalisation. Disability and vulnerability are therefore intertwined and the present book explores concepts and instruments for identifying and assessing such conditions and their human and social consequences. This would provide policy makers the inputs needed to implement policies and programmes in order to improve conditions and promote inclusion.
The international community tends to believe that whatever is done is good enough as it at least brings something to the people. And they inevitably refer to absence of infrastructure, poverty, natural disasters as the major problems to be addressed. The development effort of the last decade in Afghanistan, where the international community has contributed too little to improve circumstances of Afghans, and certainly less than what was expected and announced, shows that such a belief is deemed to always bring discontentment and disappointment. Lack of knowledge of what the Afghans really need and want is primarily the cause for the current situation.
Therefore evidence –based knowledge is necessary to try to disentangle the complexity of what disability and vulnerability are in a context of war and turmoil. This is undoubtedly a growing, ongoing and salient issue. Understanding the interaction between disability and vulnerability in such a context requires analysing how people cope in everyday life: Their capacity to survive in the midst of war, deprivation and sometime, what is worse, social exclusion.
Resilience with social support is in the Afghan psyche fundamental to survival. We also need to understand what disabled people, as well as other vulnerable groups, would choose to be and to do if the barriers they face
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were removed. Development, in the perspective of the capability approach of Nobel Prize in Economic Sciences Amartya Sen and philosopher Martha Nussbaum, is about improving well-being by providing more opportunities to individuals and groups, and addressing constraints that prevent them from being and doing what they value.
This work is driven by concerns for justice and equity. It stresses on attention to justice by recognizing the specificity of those who are excluded due to impairment, or another condition, and by providing the means to restore dignity and self-esteem, and bears a concern for equity expressed in the denunciation of inequality.
Part of the present book is inspired by the results of a nationally representative household survey that looked at the circumstances of people with disability in Afghanistan. Other chapters are based on the field experience of the authors who draw useful reflexions from their professional practice. All learned a lot from the years they spent in the country and try to share this amazing experience with the reader. The latter might find it edifying and reproducible elsewhere.
The various contributions also demonstrate that policies set-up in recent years that have been mainly rights-based, focus on the individual in a context where coping strategies are also built at the family and community levels. Such policies place people who are isolated, at a disadvantage. Increased participation of vulnerable persons also require involvement of families and communities instead of holding a discourse at the individual level, which can be seen as irrelevant by Afghans because too far removed from their own world view. This shows the need to adapt development frameworks to local realities, including taking ethnic and regional differences into consideration, an important idea in development studies that the authors of the present book, through the example of disability and vulnerability in Afghanistan, demonstrate to be still undervalued.
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Acknowledgements The editor is grateful to Nora Groce, Ray Lang, Maria Kett, Anu Bakhshi Nicki Bailey and Ellie Cole for comments on early drafts of this book, to participants of the NDSA for their commitment to this study as well as to the respondents of the survey and their family for their warm welcoming, their patience and their trust. The study was supported by the European Commission, UNOPS/UNDP, UN Mine Action Center for Afghanistan (Voluntary Trust Fund), Handicap International, French Embassy, Swiss Agency for Development and Cooperation and Leonard Cheshire International. Jenny Wickford (chapter 7) is grateful to Fiona Gall, Zemarai Saqeb, Anne Hertzberg and Ian Edwards for their constructive feedback, comments and discussions about this chapter. Special thanks go to the Afghan physiotherapists in RAD who have put up with my incessant observations, note-taking and questions which ultimately enabled this chapter to evolve.
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Table of Contents Foreword _______________________________________________5 Acknowledgements_____________________________________________7 Table of Contents ______________________________________________8 List of Tables _______________________________________________9 List of Figures ______________________________________________10 List of Abbreviations __________________________________________11 Introduction: Disability and vulnerability in a conflict affected fragile state; learning from the Afghan experience____________________13 Chapter One: Capability and disability: Approaches for a better understanding of disability issues _________________________________23 Chapter Two: The historical and cultural context of disability in Afghanistan ______________________________________________47 Chapter Three: Profiling and understanding people with disabilities in Afghanistan ______________________________________________75 Chapter Four: Deconstructing myths; facing reality. Understanding social representations of disability in Afghanistan. __________________103 Chapter Five: A gender analysis of disability, vulnerability and empowerment in Afghanistan ___________________________________123 Chapter Six: CBR in Afghanistan: Foreign import or home-grown development? _____________________________________________161 Chapter Seven: Considerations for enhanced community based physiotherapy services in Afghanistan. ___________________________193 Chapter Eight: Mental health and primary care: Fighting against the marginalisation of people with mental health problems in Nangarhar province, Afghanistan ________________________________215 Chapter Nine : ‘Today I feel that I’m a person….’: Impact of community education on disability issues in Afghanistan _____________243 Conclusion _____________________________________________269 Glossary _____________________________________________273 Notes on contributors _________________________________________281
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List of Tables Table 2.1. Literacy Rates: Comparing household surveys 64 Table 3.1. Set of questions in the screening tool of the NDSA: Prevalence and Typology _______________________________________80 Table 3.2. Set of questions in the health module according to the 9 dimensions of well-being: Severity or ‘Depth’ of a given Difficulty ______________________________________________82 Table 3.3. Prevalence rates and distribution of the population by types of disability___________________________________________87 Table 3.4. Profile of disabilities______________________________88 Table 3.5. Access to public and private health facilities ___________90 Table 3.6. Transportation to Health Facilities ___________________91 Table 3.7. Health expenses _________________________________91 Table 3.8. Barriers to Seeking Health Care Services______________92 Table 3.9. School Attendance according to Gender and Age _______93 Table 3.10. Function or Activity Difficulty and School Exclusion, Primary Education Completion and Literacy Rate ___________94 Table 3.11. Main Reasons for Lack of Access to Education according to Age Categories and Gender ___________________________95 Table 3.12. Access to Work (15-64 years old) ___________________97 Table 3.13. Child Labour (6-14 years old) ______________________98 Table 3.14. Perceptions of the cause of disability _________________99 Table 5.1. Education for Children between Ages of 7 and 14 ______135 Table 5.2. Literacy Rates __________________________________136 Table 5.3. Variables used in the MCA________________________152 Table 6.1. CBR framework ________________________________165 Table 7.1. Differences in physical therapy roles ________________206 Table 7.2. Which organisation does something useful for you? ____207 Table 8.1. Training of Trainers for doctors ____________________226 Table 8.2. Training of Trainers for Psychosocial workers_________226 Table 8.3. Training of doctors: an example ____________________229 Table 8.4. An example of a support group ____________________232
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List of Figures Figure 5.1 Access to education according to age of disability and gender _____________________________________________137 Figure 5.2 Access to education according to age of disability, gender and age categories ______________________________________138 Figure 5.3 Gap in access to school according to gender and type of disability for persons aged 7 to 14 _________________________139 Figure 5.4 Literacy rates __________________________________141 Figure 5.5 Literacy rates according to age of disability and gender for persons who accessed public school _____________________142 Figure 5.6 Literacy rates according to type of disability and gender all ages above 9 ________________________________________143 Figure 5.7 Axes 1 and 2 of the multinomial correspondence analysis on vulnerability potential factors and literacy for persons aged above 12 _____________________________________________145 Figure 5.8 Attendance rates by sex for persons with disability and non-disabled aged 7-18 ____________________________________147 Figure 5.9 Attendance rates by sex and age groups for persons with disability and non-disabled __________________________148 Figure 5.10 Axes 1 and 2 of the Multinomial Correspondence Analysis on factors of vulnerability for persons aged above 10. ________154 Figure 5.11 Classification in 7 clusters on all Dimensions of Vulnerability for persons aged above 10. __________________________155
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