The impact of disability on household poverty in Chuadanga,

Bangladesh. Dermot Foley

Teachers College, Columbia University

Poverty and Disability

• Poverty - In the CBN method, the poverty line is defined as the sum of the food poverty line, the monthly cost to meet the caloric requirement, and the non- food poverty line, and the minimum expenditure to meet basic needs (Japan Bank, 2001).

Social Model of disability• Often peer readers would want justifications for

our lack of iron-clad disability categories and focus on the context being navigated by our participants as opposed to the clinical definitions of their impairments.

• The social model of disability enables a focus on a cultural and contextual level where ‘disability is a form of social oppression involving the social imposition of restrictions of activity on people with impairments and socially engendered undermining of their psycho-emotional well-being’ (Thomas and Corker, 2002, pp.19).

Economic trends in Bangladesh• Increases in nonfarm income, from 42% in

1988 to 56% in 2004, and per capita income (Cherdchuchai and Otsuka, 2006).

• An analysis of poverty rates from 1991 to 2000 in Bangladesh demonstrate a marked decrease in poverty in rural areas, 53% to 44%, and urban areas, 34% to 26% (Sen, 2003).

Quality of life

• In 2000, Bangladesh was second only to Sri Lanka in lowest infant and under-five mortality in a regional comparison that included: Bhutan, India, Maldives, and Nepal (Grant, Hulme, Moore, & Shepherd, 2004).

The gap between rich and poor

• In a long ranging study of Bangladesh’s economic development over the past thirty years, Haque (2007) notes, “when we look at the distribution of income in terms of income shares at the top and bottom deciles, their quotient and differences and the Gini index, we found the income distribution in Bangladesh has worsened with the progress of economic development” (pp. 32 ).

National disability rates• Historically, national statistics on the

prevalence of disability in Bangladesh are a contentious issue.

• While some low rates, from .64% to 1.6%, were purported by the government based on surveys in 1982, 1986, and 1998, more recent estimates from Action-Aid Bangladesh, Bangladesh Protibandhi Kallayan Samity, and Social Assistance and Rehabilitation for the Physically Vulnerable estimate 7.8% to 8.8% (Alam, 2005).

Chuadanga • A south-west district in the Khulna Division, Chuadanga

is 300 km south-west of the capital city Dhaka and a population of 1,007,130 people in 2006 (Bangladesh Bureau of Statistics, 2006).

• A baseline survey by Impact Foundation Bangladesh in

Chuadanga of 4,528 households revealed a disability prevalence of 5.7% (IFB, 1997).

• Of the 256 households with one or more members labeled with a disability, 61 per cent had less than .2 ha compared to over sixty percent of their peers who had more than 1.ha (IFB, 1997).

• Chuadanga is a district characterized by low income, lack of fiscal resources and a general lack of support from non-governmental organizations and government agencies.

Poverty in rural districts• Rural areas in Bangladesh that depend on

the agricultural industry for employment such as Chuadanga have precarious poverty rates, which were highlighted in the late 1990s.

• Overall, for these regions the poverty rates increased in 1996 and 1998 because of flood damage and decreased in 1999 in many rural areas due to bountiful harvests (Japan Bank, 2001).

Employment• Unemployment rate- 51.8% men and

97.2% women (Bangladesh Bureau of Statistics, 2003). Chuadanga has the lowest female employment rate in Bangladesh.

• 64% is agriculture labor, livestock, and forestry with business a far second at 14% (Bangladesh Bureau of Statistics, 2006).

Our fieldwork• Using purposive sampling, we selected 40

households. Our focus was the onset of disability since 1997 and chronic poverty.

• The sample size was equally categorized into four types of disability: blindness, orthopedic impairments, hearing impairments, and mental disorders.

• Also, we selected 32 unaffected households, those without a member who has been labeled with a disability, for a comparative analysis of the current socio-economic structure.

Chronic unemployment

• 87% of the participants who are labeled with a disability left full-time employment within the first year after diagnosis.

• For participants labeled with a disability five years or longer, the employment rate fell from 13% in year one to 2% in year seven.

Unemployment and occupation

• Participants with white-collar, non-labor, jobs fared far better in terms of staying employed after onset of disability. For instance, 78% of the shop owners remained employed compared to zero for blue-collar professions such as rickshaw driver.

Economic burden/ social isolation • Of the 90% of wives who noted an

increase in the time required to care for their partner after onset of disability, 26% forego 15 hours, and 28% forego 26 hours of paid work per week than before onset.

• 80% of unaffected households gradually find a place in the upper rungs of the social and economic ladder, given the uninterrupted employment spans (of both male and female earners) and relatively lower medical expenditure.

Gender discrimination • The problems faced by women labeled with

disabilities are often overlooked and treatment expenditures consistently decline after the age of 44, irrespective of household status.

• Expenditure is highest with males in the 35-44 year age group, but the difference between average expenditure of the remaining age groups is not statistically significant.

• Relative expenses on treatment for the age group of 45 to 55+ are higher than that for the age group of 15 to 34.

Social Networks• In developing countries such as Bangladesh, the

lack of formal state-provided services often forces people to seek help in social networks (Momin, 2001).

• These networks provide crucial emotional and practical support and, additionally, facilitate access to formal services, if there are any.

• The absence of social connections makes it far more difficult to break away from poverty and ill health (Barry, 1998).

Discussion• Often, the outcome of onset of disability is

rapid depletion of assets, increased financial and social burdens on the family, isolation from the community, increased debt, and impoverishment.

• In our study, the direct cost of treatment and equipment of affected families varies from 5 days to 1 year's worth of normal income, with the average being 4 months' worth.

• Micro-credit lenders exponentially increased in Bangladesh with more than 1000 opening since 1990 and offering interest rates from 10% to 30% (Chowdhury, Ghosh, & Wright, 2005).

• The micro-credit programs in Chuadanga offered by organizations like BRAC and Grameen Bank stress their preference for women borrowers, so as to empower them and make them self-sufficient (Johnson and Rogaly 1997).

• The schemes work on a peer-group basis with delivery systems such as the Bangladesh Rural Advancement Committee (BRAC) and the Association of Social Advancement (ASA). Often, defaulting on loans by any member is the responsibility of the entire group (Johnson and Rogaly 1997; Thomas, 2000).

• Of our participants, 8 per cent of women labelled with disabilities are members of credit-providing non-governmental organizations, as compared with 90 per cent of able-bodied women.

• Women labeled with disabilities, or even the mothers and wives of those thus labeled, often find themselves excluded from all such lending groups, as they are perceived as ‘high risk payers,’ implying that there is a higher probability of non-repayment among those labeled with disabilities.

• This is consistent with the findings of Lewis and Sygall (1997) in their study in Tanzania and Malawi.

• The economic opportunity of an increasing non-farm labor force in Asian counties is a reality but who gets those opportunities now is limited to those without disabilities and, in some cases, without family members with disabilities.

• Regardless of disability, the move from the farm to non-farm sectors of employment is impossible without, “the acquisition of financial and human capital to apply the know-how of a new livelihood strategy” (Nargis and Mahabub, 2006, p.434).

• Hoque (2004) proposes closer supervision of marketing micro-finance programs to promote investment in income generating activities and making the loans larger for entrepreneurial endeavors.

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• Solutions to these problems are complex. In part, we have to collectively consider how the context of discrimination against those labeled with disabilities and their family members negates broad based programs intended for the impoverished.

Thank you.