Rehabilitation Therapy in Government Hospitals

Before the enactment of Rights of Persons with Disabilities Act -RPWD Act in 2016, the Persons with Disabilities Act (PWD Act 1995) was in operation for many years. In the RPWD Act, 2016, the list of disabilities has been expanded from 7 to 21. This now also includes cerebral palsy, dwarfism, muscular dystrophy, acid attack victims, hard of hearing, speech and language disability, specific learning disabilities, autism spectrum disorders. In addition to it chronic neurological disorders such as multiple sclerosis and Parkinson’s disease, blood disorders like hemophilia, thalassemia, and sickle cell anaemia, and multiple disabilities have also been included under RPWD Act 2016.

The nomenclature of mental retardation is replaced by intellectual disability which is defined as a condition characterised by significant limitation both in intellectual functioning (reasoning, learning, problem-solving) and in adaptive behaviour which covers a range of everyday social and practical skills including specific learning disabilities and autism spectrum disorders.

Rehabilitation therapy in Govt hospitals

The RPWD Act 2016 provides an elaborate definition of mental illness which is “a substantial disorder of thinking, mood, perception, orientation, or memory that grossly impairs judgment, behaviour, and capacity to recognise reality or ability to meet the ordinary demands of life but does not include retardation which is a condition of arrested or incomplete development of mind of a person, especially characterised by sub-normality of intelligence. Persons with benchmark disabilities are defined as those with at least 40% of any of the above disabilities. At a time when we have a huge number of people suffering from different disabilities as mentioned above , do we have enough trained people to manage them? At Govt level we have only one or two institutions where we have trained people providing rehabilitation therapy to such people. Most of the parents who need rehabilitation therapy for their children visit private clinics and unfortunately most of our population can’t afford this. People from lower income groups, disadvantaged communities due to lack of financial resources are not able to get proper treatment or rehabilitation therapy for their loved ones. These children or even adults continue to suffer from mental ailments and other physical or psychological disorders which otherwise is manageable.

Who is a Rehabilitation Therapist ?

A Rehabilitation Therapist is a trained and qualified professional having Bachelors Degree in rehabilitation therapy also called BRT. This is a 4 ½ years degree course which is monitored by Rehabilitation Council of India (RCI). The BRT graduates are trained specifically to deliver the rehabilitation services to the ignored section of the differently abled persons of the society, especially children suffering from various kinds of disabilities. The Rehabilitation Therapist is trained and qualified managing people suffering from mental retardation , neurological problems, locomotor disability, impaired vision, autism speech and language problems, cerebral palsy etc. The Health Department in J&K is not providing rehabilitation therapy in any of its hospitals from Primary Health Centre (PHC) to District Hospital. As the number of persons with disabilities is increasing day by day the Govt needs to avail the services of these trained professionals. The cases of mental depression , stress have increased during the last 2 to 3 years especially after the COVID 19 pandemic, but most of these people do not get proper treatment and rehabilitation.

Creation of Rehabilitation Therapist Posts

While realising the need and necessity of the services of Rehabilitation Therapists, the Health and Medical Education Department vide Order No.HD/189/2017 Dated: 29.5.2019 asked the Directors of the health department Kashmir / Jammu to submit a detailed proposal, justification along with financial implication for the creation of posts of Rehabilitation Therapists in J&K. The proposals were submitted by the Directors of health services Jammu / Kashmir. The Director Health Kashmir vide his letter No.DHSK/ Plg / Creation/19/2001 Dated: 16.09.2019 recommended 90 posts of Rehabilitation Therapists at the District hospitals, Sub-District hospitals, PHCs and Community Health Centers (CHCs) across Kashmir. But even after more than 3 years, the Govt has not created these posts . The Director Composite Regional Center-CRC Bemina Srinagar vide his letter No.CRC/Sgr/state-corps /21/195 Dated 4.08.2021 addressed to Financial Commissioner Health and Medical Education Department urged for the early creation of these posts in view of the utmost need of their services in view of extension of RPWD Act 2016 to J&K post article 370 abrogation, but till date there is lukewarm response on this issue from Govt.

Healthcare for PWDs

The Government has also been given the responsibility under RPWD Act 2016 for ensuring that it protects and promotes the health of persons with disabilities. The provision on health is divided into two parts. One part is related to ensuring that healthcare facilities reach people with disabilities. In the second part the Government is required to take steps for prevention of disabilities. To ensure that people with disabilities are able to access healthcare facilities the Government has to provide

1.
Free health care closer to the place where persons with disabilities reside especially in villages, but this facility is provided free of cost only to those who fall within a particular income ceiling as determined by the Government.

2.
People with disabilities should be able to access all parts of a Government, private hospital or healthcare institution without facing any barriers. The building should be accessible. The cost of healthcare is to be such that it can be afforded by those with disabilities. The facilities within these hospitals should be such that persons with disability are able to easily access.

3.

When persons with disabilities visit the hospital they should be attended to and treated in priority. This means that hospitals could create separate queues for them or treat them first in a line of patients. The Government has also been given the responsibility of preventing the occurrence of disability broadly by two methods – through awareness and training amongst people and through active interventions in the area of health.

Conclusion

Better and free healthcare facility is the right of persons with disabilities (PWDs). This includes facilities for rehabilitation therapy as well for PWDs. If RPWD Act 2016 has been extended to J&K more than 2 years back , why isn’t the Govt providing rehabilitation services to PWDs in Govt hospitals across J&K? There are only a handful of such institutions which provide these services free of cost, but we need the services of qualified Rehabilitation Therapists at sub district and district level, so that persons with disabilities (PWDs) don’t have to travel huge distances. I would also appeal to the Govt to appoint the State Commissioner under the RPWD Act 2016 which is the nerve center for implementation of this great piece of legislation.

Dr Raja Muzaffar Bhat is an Acumen Fellow. He is Chairman & Founder of JK RTI Movement….

Disclaimer: The views and opinions expressed in this article are the personal opinions of the author. The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK.