According to the World Bank, 98 percent of all children with disabilities in developing countries are not in school.  About 40 million children with disabilities of primary school age are not receiving an education.  This includes children who have only a single disability, for example sighted deaf children without mental retardation, learning disabilities, or mobility impairments.  What then of deafblind children?  Or deaf children with mental retardation?  Or deaf children with any other combination of additional disabilities?  (NOTE: the World Bank link may not work well in Netscape, but should work in Internet Explorer.)

        It is often difficult to find reliable, documented information on deaf children or adults in developing countries.  Finding reliable information on specific sub populations, such as deaf children with additional disabilities, is even more difficult.  This knowledge does exist--but in bits and pieces, locked away inside the heads of hundreds of people around the world who have worked directly with, or at least visited and observed, programs for deaf children in developing countries.  I wanted to gather together some of these little pieces of information into one place, even if only in an informal fashion.
 

Finding the Information
        This project began, primarily, as an informal survey of people I already knew via email who either live and work in developing countries or who live in developed countries but who have traveled extensively.  Many of my initial contacts were not able to assist within the time frame available.  Some may not have seen my email message at all.  People in developed countries who work in the international field travel extensively and may be away from email contact for weeks or months at a time, while people in developing countries, for various reasons that I will not elaborate upon here, often have unreliable email access and may also go weeks at a time without being able to check email.  Other contacts simply did not have the time to reply.  Those who are actively working with deaf communities in developing countries often consider their work to be tantamount to a "calling" and may have little time to devote to any task that does not directly benefit the local deaf community.  Also, people in developing countries are more likely to have two or more jobs simply to survive, and thus still have little or no time for email.

        Nevertheless, some people did reply, either to share information or to suggest further contacts or to point me to resources on the web or elsewhere that might assist.  Some of my "second generation" contacts referred me to still more possible contacts.  During the past two weeks, I have sent out email messages to about 59 individuals around the world.  I also sent email messages to three list servers: one, deafintl , is devoted to deaf people in developing countries; another is for deaf people in or from Africa; and a third is exclusively for women with various disabilities who participated in a recent leadership training program, Women's Institute for Leadership and Development, that took place in Eugene, Oregon, last fall through the organization Mobility International USA.
 

My Sources
        Ultimately, I gathered information from the following sources:

              > More than a dozen individuals sent me partial or complete replies to my questions.
                      - Most emails were very brief.
                      - However, a few individuals were able to answer follow-up questions.
                      - One individual went the extra mile by personally visiting schools in Lahore, Pakistan, in an attempt to gather information.

              > One individual sent me her 43 page masters thesis, written entirely in Spanish, which contained some relevant information.  Her thesis is summarized in the section on Argentina.

              > I also consulted some web sites that were recommended to me, but particularly the following:
                      - Perkins School for the Blind
                      - Sense International
 

Disclaimer
        It should be noted that, for most countries, I only had one contact or other source of information.  Even people who have been active for many years within the deaf community of a given country are not necessarily familiar with all resources available to that community, particularly when it comes to resources that might be available in a different part of the country, or resources outside their professional field, or resources targeted at a sub population within the deaf community in which they have not specialized.  The information shared in this document, accordingly, should not be considered complete even in the few cases (e.g., Kenya) where I received responses from more than one person.

        In some places, I included quotes from the people who shared information with me.  In all of these cases, the quotes reflect the tone, opinions, attitudes, and sentiments of the person quoted.  The inclusion of a given quote does not imply that I necessarily agree or disagree with the person's position.
 

The Organization of This Presentation
        I have organized the information I gathered into regions: Africa, Eastern Europe, and the Middle East; Asia, including South Asia and the Pacific Islands; and Latin America.  A separate resource section is provided at the end.
 

       AFRICA:                    Cameroon, Croatia, Jordan, Kenya, Malawi, Nigeria, Somaliland, Uganda

       ASIA:                         Fiji, India, Malaysia, Pakistan, Viet Nam

       LATIN AMERICA:    Argentina, Bolivia, Ecuador, Guatemala, Nicaragua

       RESOURCES:           Argentina, Cameroon, Croatia, Fiji, Kenya, Malawi, Malaysia, Uganda, Other Resources
 
 

Cameroon
        Ebot Ntui Ogork, the Executive President of the Cameroon Deaf Empowerment Organization (CDEO), was my contact for Cameroon.  The CDEO was established by some parents of deaf people and other individuals concerned with the advancement of deaf people.  They have run the Ephphatha Institute for the Deaf in Kumba, Cameroon, since its founding in September 1996 with limited support from the Cameroon Ministry of Social Affairs, the German and U.S. Embassies, and the British High Commission in Yaoundé.  CDEO also teaches sign language to Deaf and hearing people in Cameroon, but particularly to parents of deaf children, and also students at Yaoundé University and the social affairs school.  In addition, they have run deaf awareness campaigns, and have educated deaf people about HIV.  They want to construct a high school for graduates of the Ephphatha Institute because some of these students are presently roaming the streets without employment or education.  Another of their priorities is establishing income generating projects.

        Ebot Ntui Ogork told me, "Deaf children with additional disabilities, especially the physically disabled, exist in Cameroon. Some of the deaf children are also mentally retarded or even have mental disorders. Since educational opportunities for deaf people without other disabilities are very limited in Cameroon and public deaf awareness is still low, I am not aware of the existence of any schools, social services, agencies, or programs in Cameroon that specifically target deaf students with additional disabilities. In our deaf school, the Ephphatha Institute for the Deaf ( EID), in Kumba, South West Province, Cameroon, there is one 15-year-old boy with mental disorders.  We have just admitted him to study alongsideÊdeaf children with no other disabilities because there is no specialised schools for such cases, therefore there is an urgent need for such schools in Cameroon."

        SEE ALSO Cameroon resource listings further below.

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Croatia
        Martina Stabi, who works with the Croatian Association of Deafblind Persons, indicated that there are no schools or social service agencies in the Republic of Croatia that target deaf people with additional disabilities.  The only organization that provides education to Deafblind children is the Croatian Association of Deafblind Persons, Dodir, which has been organizing outreach programs for children at their homes and at one long stay hospital.
This program currently includes five children.  Sometimes deaf students with additional disabilities enroll at schools for deaf children in general, but these programs do not usually adjust to their needs, so their drop-out rate is reportedly "very high."  Stabi does not know of any other schools that accept deaf children with additional disabilities at all.    The only primary and secondary school for deaf children in Croatia are in the capital.

        Stabi indicates that children with disabilities are usually identified either after birth, if their parents seek out social benefits, or at preschool age when they need to be placed in a school program.  The Croatian Association of Deafblind Persons does not have information on how the decision for placement is usually made.  There has been no research into the family life of deaf children with additional disabilities, or the impact of their presence on the general community, or what happens to these children once they become adults, or the most common causes of multiple disabilities in Croatia.

        SEE ALSO the Croatia resource listings further below.

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Jordan
        Jordan has a program called the Holy Land Institute for the Deaf (HLID).  Matthew Hanning, the HLID administrator, indicated that they have a small deafblind unit with four deafblind students.  In addition, HLID has three deaf students who also have mild to moderate cerebral palsy, and some additional students who have Ushers Syndrome.  He was not aware of any other programs in Jordan that specifically target deaf students who have additional disabilities.  Hanning indicated that there are very few facilities able to meet the needs of children with disabilities in Jordan.

        SEE ALSO the Jordan resource listing further below.

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Kenya
        In Kenya, I was fortunate to receive replies from two contacts: one from a missionary named Kirk VanGilder who has traveled frequently to Kenya to work there, and another who works in the field of deaf education in Kenya.  In Kenya, children who survive malaria at a young age often experience some cardiopulmonary damage.  In addition, there are some children in northern Kenya, near the Somaliland border, who have survived land mine blasts with the lost of a limb or an eye.  There are also many deaf children with cerebral palsy.

        VanGilder reports: "The Njia Special School in Maua, Kenya, is a school that is both special education and deaf education.  They do have some deaf kids who are 'just deaf' as well as some who have multiple disabilities.  It's quite an amazing place considering it was built from 'nothing' in 1990.  It's quite a story.  The Kaaga School for the Deaf in Meru, Kenya, is a 'deaf school' proper.  While it has some deaf kids with multiple disabilities it's not specifically focused on the education of such children."

        VanGilder goes on to explain, "The Disabled Children's' Centre was specifically set up for the purpose of accurate diagnosis and informing parents about options for education.  They do a lot of village visits to advocate for the welfare of disabled children.  I vividly recall their three main points when visiting a village for the first time 1) Do not kill your disabled children 2) Feed your disabled children just as much as you feed your other children 3) Show your disabled children as much love and attention as you do your other children.  Given the extreme poverty faced by parents, disabled children often get overlooked.  Their goal is to give parents resources and information as well as assistance.  Njeru Muchiri does a lot of going to the villages too.  The district education office of the Meru North district of Kenya charged him with identifying children in need of special education.  I believe it was in 1998 when we visited the first time they had an 8 year old school with 33 students and a waiting list of over 300."  Njeru Muchiri is a Kenyan educator who founded the Njia School "on a dream" in 1990 with funding support from Plan International and the Methodist Church of Kenya.  He has been recognized in Britain for his work in the field of special education in Kenya.

       Deaf Kenyan children in boarding school often appear very "down" or depressed when it is time to go home for vacation, except for children who have deaf parents.

        According to VanGilder, "Paul Lindoewood was helpful in establishing a Disabled Citizens Council in Maua of deaf adults.  From what I gathered from their organizational meeting (we were guests at their formation meeting in 2000) once formally organized, they can apply for funds from the government for things like work projects etc.  How much they get given the level of corruption is minimal.  But organizing also allows them to approach international aid groups.  The group we saw in Maua in 2000 was looking in particular to make a workshop to make mobility aids."

        My other contact was Paul Lindoewood, who was referred to me by Kirk VanGilder.  Lindoewood, a British man with severe cerebral palsy, is a missionary of the Methodist Church of Kenya.  He was instrumental in founding the Disabled Children's' Centre; he travels around Kenya into the wildest rural areas with a motorized wheelchair, a van, and a driver.  Lindoewood obtained information from the Centre's education worker.  According to this worker, some of the most common causes of multiple disabilities in Kenya include inheritance, German measles (Rubella), Meningitis, Jaundice and high toxic drugs during pregnancy, and premature birth.

        Identification and diagnosis is conducted at the Education Assessment Resource Service (EARS) Centres at the District Level.  The education worker indicated that "the community often regards disability as a curse and they will discriminate against the disabled persons.  There is not much information about deaf adults with additional disabilities as here in Meru North, most of our data is to do with children."  There are some schools specifically for deafblind children in Kenya.  Deaf children with physical disabilities are generally enrolled in schools for deaf students.  Some deaf children are placed in schools and units for "mentally handicapped children."  There are a total of 34 primary schools or units for deaf children in Kenya and two seconday schools.  There are also two colleges for deaf students in Kenya.

        SEE ALSO the Kenya resource listing further below for additional information on deaf education in Kenya, including more details about the deaf and deafblind schools there.

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Malawi
         Doreen Woodford from the Deaf Africa Fund, who is familiar with deaf education in Africa generally, informed me that she has been told that there are no programs in Malawi that specialize in serving deaf children with additional disabilities.

        There are, however, a few schools for deaf children in Malawi, including one school called the Embangweni School for the Hard of Hearing that was established in 1996 with 42 children.  I was able to obtain further information about this school from a hearing American speech pathologist who has traveled frequently to this school.  Today, this boarding school has 120 students in pre-school and primary school and were to have expanded their program up to Standard 7 with the new school year in January this year. They have been thinking of developing a vocational or life skills program for some of their older, teenaged students.  About three quarters of the students at this school use solar powered hearing aids.  (My contact did not elaborate on this point, but given my knowledge of developing countries generally, the children were most likely given solar powered hearing aids so that their families would not need to experience the severe financial burden of choosing between spending their money on the food they need to survive and hearing aid batteries for their children.  Hearing aid batteries commonly cost about $1 each even in the United States where we do not need to concern ourselves with import fees or taxes.  They are often even more expensive abroad.  The average person in Malawi lives on far less than $1 a day.)  The children are not always fitted properly for ear molds--at best, their ear molds are "about right."  The hearing aids do amplify sound well, but cannot be adjusted to the individual needs of children with different types or levels of hearing loss.

        Of Embangweni, my contact said, "We do get the occasional child who seems to have some other problem such as mental retardation.  I think there was a girl there last fall who was autistic; another boy I had several years ago was also likely autistic.  They generally do not stay long, as the teachers are not trained to deal with them and the resources simply can't be stretched to handle any other problems."  Due to lack of appropriate technology and other resources, children with disabilities in Malawi rarely, if ever, receive a formal evaluation or medical diagnosis.  According to my contact, "It is pretty much 'kid can't hear, must be deaf'; 'kid doesn't see, must be blind'; 'kid has no movement in legs, must be paralyzed.'  The ones I have guessed at being autistic or possibly ADHD and one I suspected with auditory processing disorders are out of luck.  Even if there were procedures and places for diagnosis (which there aren't), there would be no organization for follow up or treatment.  I suspect they go back to the village and at best learn by observation and by doing the basic tasks needed for survival: getting water and wood, planting and harvesting maize, cooking.  At the worst, their life expectancy is likely less than the average 34 years for other Malawians."

        In commenting on the tone of her email, my contact said, "I'm thinking this sounds very 'down' but it is reality in the third world.  Life is so focused on maintaining life itself that there is little time, energy or resources left to improve the lives of those with disabilities.  We rejoice that our school and the few others even exist and can continue to function.  We will not change the lives of all the disabled in Malawi, but we will make the lives of a few better and more hopeful.  I wish you could visit with us and see the pride the kids take in their education and the enthusiasm of the teachers!  Maybe one day...."

        Despite the lack of resources and formal programs and services, however, people with disabilities tend to be better accepted in Malawi compared to their reception in some other cultures such as Kenya and elsewhere.  According to my contact, "Families and others are kind to them, generally.  I often see folks with very obvious mental disabilities wandering around the town and outlying villages.  They are never harassed but if they become bothersome (like the lady who threw rocks at me as I was preaching!), someone very gently distracts and leads them off.  This is a very family oriented society, so I think anyone with a disability is taken in if not by the immediate family, by the extended one.  This is what happens when children are left orphans -- the next closest kin (usually a brother or sister) -- takes the orphans in without question.  It can be a terrible burden (imagine your family growing from 6 or 8 to 10 or 16 overnight) but as far as I am aware never refused."  To her comments, I should point out that the AIDS epidemic has hit the African continent harder than any other geographical region in the world.  There is a rapidly increasing number of "AIDS orphans" in many African countries--i.e., children who have had one or both parents die from AIDS.  This phenomenon has been observed and commented upon by the Economist weekly magazine and other publications.

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Nigeria
        Someone I know in Nigeria sent me the following email: "I hope this will just give you a clue as to how deaf children are viewed and treated in my community and in Nigeria in general. There are very few schools for deaf children in Nigeria.  This is because society does not believe they can be of use to the community, and should any deaf child have any other additional disability, that child is simply hidden away from the public glare because she is seen as a cause and embarrassment to the family.  Such a child does not enjoy any form of family life.  And presently, I do not know of any special school for deaf children with additional disabilities in my country.  The deaf are the worst hit when it comes to discriminating against disabled people in my country.  I am using Benin City, Sapele, and Warrri, all of which are in the Niger/delta Region of Nigeria, as a case study."  My contact in Nigeria is a hearing woman with a physical disability.  She is a brilliant, articulate woman who is very active in the disability community in Nigeria.

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Somaliland
        Doreen Woodford at the Deaf Africa Fund reports that she has heard of a program targeted at deaf students with "slow learning needs" that is a part of International Aid Sweden.  International Aid Sweden has not replied to my inquiry about this program as of this writing.

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Uganda
        Joseph Mbulamwana, the Programme Officer Information at the Uganda Association for the Deaf, indicated that Uganda has some special primary schools for deaf students and also some units for deaf children in mainstream schools, including a few secondary schools.  There are deaf students in Uganda who attend colleges and universities with interpreters.  However, not all deaf children are able to obtain an education in Uganda.  Although the number of programs targeted at deaf students with additional disabilities is slowly increasing, "the means and personnel experienced in handling them is still lacking."  However, there are a few units available for deafblind children, for example at Ngora, and at Ntinda.  The Ear Nose and Throat departments at major hospitals in Uganda are able to diagnose deaf people and then refer them to deaf schools or units.  Hard of hearing people are able to have hear aids molded and fitted to them.

        SEE ALSO the Uganda resource listing further below.

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Other African Countries
        Follow some of the links to the international resources listed under "Other Resources" further below to find more information on organizations, services, and programs that might be of interest to other African, Middle East, and Eastern European countries.  Sense International, Perkins School for the Blind, and Christian Blind Mission, for example, all have programs working with deafblind and other people with multiple disabilities throughout the world and may also be willing to expand their programs into new countries.  Of particular interest to central and eastern European countries is the Central and Eastern European Resource Center.  Also, don't overlook opportunities to network with other people who share your interests in educating deaf children with additional disabilities in developing countries via listservers such as deafintl or PRD-L, also listed under "Other Resources."

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Fiji
        A woman I know in Fiji, named Roshni Devi, informed me that there are 14 Special Education Schools on the island that cater to children with disabilities from birth through age 17.  All of these programs are primary schools.  There are no secondary schools for people with disabilities in Fiji due to lack of resources.  The Hilton Special School has children with all types of disabilities.  My contact in Fiji indicated that she has seen some deaf children at Hilton who have additional disabilities, such as physical disabilities, including cerebral palsy.  Another school in Fiji, called the Gospel School for the Deaf, specifically serves deaf children.  My contact, Devi, is a hearing woman with a disability who is active in the Fiji disability community.

        The Hilton school does not have email, so I was not able to contact them directly given the limited time available for this project.  I did send an email to the Gospel school to find out if any of their children had additional disabilities.  Their reply simply said that they serve deaf children and referred me to the Hilton School.  It is not clear from their email whether they have no deaf children with additional disabilities at Gospel (and refer all of them to Hilton) or if they simply did not have the time to reply to my questions in more detail.

        SEE ALSO the Fiji resource listing further below for contact information for the Hilton and Gospel schools.

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India
        My contact for this country, Ronald D'Souza, is an Indian man who works at a school for deaf children India.  He does not specialize in education for deaf children with additional disabilities, and was not personally familiar with any of them, except that he has heard of three schools that are starting new programs for deafblind students.  D'Souza indicated that there is little or no documented research on deaf education in India.  He indicates that, at least in his geographical area, deaf students "who cannot cope with studies because of an additional disability end up in the schools for the mentally retarded."  The school where he works has denied admission to some deaf students because of their additional disabilities; these students usually either go to a program for children with mental retardation or receive no formal education at all.  D'Souza also points out that many people in India live in rural areas where there are no services available at all, because programs for children with disabilities are usually located only in major cities.  There are no degreed, professional training programs specifically for teachers who wish to work with deaf children with multiple disabilities in India.

        "India is a country with more than one billion people with limited resources," says my contact.  "The country has not coped with educating all the able-bodied people so far. Then how can we talk about all the Deaf people (and deaf with multiple disability) being educated?"  In recent years, however, the government and local non-government organizations have been becoming increasingly aware about the need to educate people with disabilities, including those who are deaf, or blind, or have cerebral palsy, or have mental retardation.

        According to the Sense International India web site, the majority of the estimated 450,000 deafblind children in India receive "virtually no educational stimulation at all."  Instead, most of them live in "total isolation" either at home or at schools that don't understand their needs.  Until 1997, there was only one specialized deafblind program for all of India.  Now, there are a total of 25 deafblind programs in 13 states.  A full listing of these programs is available at http://www.senseintindia.org/htmls/partners.html

D'Souza has indicated that the school he has heard of that will be adding a program for deafblind students is mentioned on the Sense International web site at: http://www.senseintindia.org/htmls/jjsb_varanasi.html

D'Souza himself will be working at the Nav Vani School for the Deaf in Varanasi at http://rehabcouncil.nic.in/accreditation_inst.html

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Malaysia
        My contact for Malaysia was Jessica Mak, a deaf woman who is now working as Programme Coordinator at the Pusat Majudiri Y for the Deaf (PMY) in Kuala Lumpur, Malaysia.  She reports that education and services for deaf children with additional disabilities are very limited in Malaysia.  She does not know of any public schools specifically targeted at deaf children with additional disabilities in Malaysia except for one program for deafblind children.  She indicates, however, that most deaf students who have cerebral palsy are able to study in schools targeted at deaf students generally, or in other special education programs.  She reports that they are treated equally to other deaf students.  Deaf students with mild mental retardation are sometimes enrolled in schools for deaf children.  Most professionals in Malaysia have no experience, training, or awareness in working with deaf children who have additional disabilities.  The PMY for the Deaf itself provides many services including a pre-school, a parent-infant program, a deaf children's development program, an employment supportÊnetwork, a family life and home management program, and more.  The PMY has helped deaf children who have autism or mental retardation obtain early identification and education, including language and psycho-social skills development.  PMY has also helped parents gain the skills they need to reinforce their child's development.  However, the PMY suffers from lack of information.

        Jessica Mak indicates that she knows of deaf adults with cerebral palsy who now work with computers and have their own families.  One has graduated with a diploma in Multimedia and Graphic Design.

        SEE ALSO the Malaysia resource listing further below for full contact information for the Pusat Majudiri Y for the Deaf.

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Pakistan
        My contact for this country is a deaf Pakistani woman, Zara Husain. She says she has personally seen a couple of deaf students with additional disabilities at local schools, but emphasized that, despite "boastful" reports from the Pakistani government about their  achievements in expanding their efforts in inclusive education, "many deaf students with additional disabilities are not in school these days for a number of reasons."  Some regular schools in Pakistan do accept students with "all disabilities."  The newest "trend" in Pakistan is toward "inclusive education."

        Husain personally visited schools in Lahore, Pakistan, in an attempt to find information about deaf students with additional disabilities in her metropolitan area.  She ultimately reported to me, however, that "There is no information on deaf students with additional disabilities in Lahore, Pakistan."  As I told Zara in my reply to her email, this is in and of itself valuable information to know.  My atlas tells me that Lahore is one of the few cities of its size in Pakistan, with a population of more than one million residents.  In most countries, any services that exist for children with disabilities at all tend to be in the larger metropolitan areas.  My atlas (admittedly old, as it is dated 1996) also tells me that about two thirds of the Pakistani population lives in rural areas, and only one third in urban areas.  If education for deaf children with additional disabilities is so rare, or possibly non-existent, that someone personally visiting schools and making an extensive search for information in her area cannot locate this information even in an urban location, then the possible implications for deaf children with additional disabilities in the rest of Pakistan are all the more disturbing.

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Viet Nam
        My contact for Viet Nam was a hearing American who has made several extended visits to a school for deaf children in Viet Nam.  He informed me, "In Viet Nam, a poor country, resources are allocated in the way that is deemed most productive or beneficial.  Students that have multiple disabilities have special schools.  I have not done work there, so I cannot comment on specifics.  Schools for the Deaf are oral and the difficulty in communicating means that Deaf students receive little education.  Those with multiple disabilities in special schools surely receive much less.  I have visited one school in Da Nang.  There are toys and a focus on the physical needs of students, since the staff knows what to do with physical needs."

        On the status of deaf education in general, my contact comments, "The general feeling with Deaf people is 'We don't know what to do, there is no training and no money, so anything we do is a help and we will do the best we can.'  Because of their culture, there is an acceptance of this.  Their culture also teaches them that doing good works for others brings rewards later, so their 'charity' towards Deaf people and others is where they put their energy.  They see themselves as caretakers.  They do not see much potential in their students.  The idea that Deaf people in the United States drive cars, get married, go to college, etc., is passed off as being a different world.  With money and training anything is possible, but they don't see there is anything they can do in their poor country.  It is therefore hard to motivate them to learn sign or teaching methods for the Deaf.  There are certainly exceptions, and the two schools I have been to are eager to learn these things."

        My contact also indicated that, during one visit to Viet Nam, he encountered a student who he suspects might have dyslexia.  However, when he spoke with the teachers, he found that they simply perceived the student as being "slow" and without much potential.  When told of techniques used in the United States with students with learning disabilities, they reacted that it was "nice" but did not seem interested in learning these techniques for use with their own student.  "Teachers don't believe there is anything to be done except to continue doing what they already do," says my contact.

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Other Asian Countries
        Follow some of the links to the international resources listed under "Other Resources" further below to find more information on organizations, services, and programs that might be of interest to other Asian, South Asian, and Pacific Island countries.  Sense International, Perkins School for the Blind, and Christian Blind Mission, for example, all have programs working with deafblind people throughout the world and may also be willing to expand their programs into new countries.  Also, don't overlook opportunities to network with other people who share your interests in educating deaf children with additional disabilities in developing countries via listservers such as deafintl or PRD-L, both of which are listed under "Other Resources."

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Argentina and neighboring countries (southern cone of South America)
        Graciela Ferioli, a woman from Argentina who has more than 20 years of experience in the field of disability education in Argentina, sent me her masters thesis that she completed last year when she obtained a Masters of Education degree in teaching students with multi-sensory impairments at the University of Birmingham in the United Kingdom.  Her thesis is entitled "Exclusión Cero: Barreras Institucionales y Educativas que Enfrentan los Niños y Jóvens con Impedimentos Multi Sensoriales y Discapacidades Adicionales y Sus Familias en el Cono Sur de América Latina" ("Zero Exclusion: Educational and Institutional Barriers that Confront Children and Youth with Multi Sensory Impairments and Additional Disabilities and Their Families in the Southern Cone of Latin America").  This 43 page document is written in her native Spanish, which is my third language.  Any flaws in comprehension, interpretation or translation are, of course, entirely my own.

        For Ferioli's thesis, she conducted qualitative interviews with three mothers of people with multiple disabilities, including two with multiple sensory impairments (i.e., deafblind people), in the Southern Cone of South America.  These mothers were chosen because, in addition to having their own children with multiple disabilities, they were also leaders in parents' groups and were consequently able to speak from the experiences of other parents as well as their own lives.  Ferioli also chose mothers who had children aged 13 or older to ensure that her participants would be able to speak from long-term experience with the educational system; she ascertained from professionals working in the field that very little has changed over the years since the children of these mothers were still young.  She triangulated these interviews with interviews of four professionals in different specialties who were familiar with some or all of the cases included in this study.  The purpose of Ferioli's study was to identify the causes of barriers that tend to prevent children with multiple disabilities from obtaining an education.

        Ferioli indicates that, until the 1960s, there were no programs for students with multiple disabilities in this region.  Enrollment has been increasing since that time, but is still limited.  Before children with multiple disabilities had access to an education, many were most likely in orphanages, institutions, or simply in their homes.  If I understood the Spanish correctly, it is estimated that there are about 163 programs that serve about 2,200 children with multiple disabilities in Latin America, and of these, about 4 percent are deaf and blind.  Students with multiple disabilities tend to be the last students to be included in public schools.  The community at large tends to perceive people with multiple disabilities as patients to be taken care of, not as participating members of society.

        According to Ferioli, the following elements are critical to the successful inclusion of students with disabilities in public schools:  1) A shared vision among administrators, parents, students, members of the community, and other stake holders to promote inclusion; 2) Administrative support, particularly the director of the school; 3) The development of appropriate skills in the personnel participating in the inclusion; 4) Time for communication and cooperation among personnel; 5) A process of providing advice specific to promoting successful inclusion; 6) Permanent availability of direct services, advice, and resources for personnel in inclusive schools; 7) The support of non disabled peers, and opportunities for non disabled students to interact with students who have disabilities.  Ferioli emphasizes that simply having the knowledge of how to implement inclusion is not enough--personnel must also have appropriate support.

        Presently, there is a severe lack of coordination in effort among specialists.  Says Ferioli, each specialist sees "al niño como un conjunto de síntomas...sin ver el panorama general" (sees the child as a conjunction of symptoms without seeing the general panorama).  This can sometimes result in conflicting or even counterproductive recommendations from various professionals to the parents of a child with multiple disabilities.  Children with multiple disabilities tend to be addressed in a fragmented, pathological manner.

        Both parents and professionals in Ferioli's study agree that children with multiple needs tend to receive late diagnosis for various reasons, including lack of awareness among professionals about disabilities, lack of coordination among health and educational services, generalized dehumanization, and lack of information among the families.  Parents indicates that some professionals never communicate directly with their child, they only speak about them.  One mother points out that every hospital for children has at least one or two children with disabilities why aren't nurses better prepared to work with them?

        There also tends to be limited communication between professionals and parents.  Parents perceive educators as lacking in confidence in their own ability to teach students with additional disabilities.  Parents opinions and input tend to be overlooked, or parents may even be blamed for certain problems observed in their children.

        Participants in Ferioli's study suggested that some parents may decline to fight for their own rights because they are not aware of their rights, or because they lack the information and preparation they need to reclaim their rights, or because they are already worn down from the search for multiple opinions from multiple specialists for their children, or they are simply tired of fighting.  They feel alone and overwhelmed with tremendous economic demands and the near lack of support from authorities.  Ferioli points out that the community must protect families and their rights, or no child in any family will enjoy human rights.

        Some public schools in special education are now starting to become interested in revising their institutional objectives to better meet the needs of children with multiple disabilities, in part because of political pressure resulting from the activism of parents.  Regulations also support the inclusion of children with multiple disabilities.  However, some barriers remain.  For example, some administrators do not facilitate admission for students with multiple disabilities, whether due to lack of competence, or because the authorities do not designate enough professionals for this population, or for lack of resources.   Ferioli asserts that cooperation between parents and professionals cannot occur if professionals have no incentive to pursue this cooperation.

        Parents who insist upon their rights or who make demands are often seen as "problem parents" rather than people seeking information to meet their children's needs.  Many professionals simply do not perceive parents as collaborative partners but, instead, as passive recipients of services.  Ferioli recommends that professionals should work as a team with each other and with the family to avoid conflicting, counterproductive recommendations.  Instead, each child should be treated holistically, in part to make it easier to visualize the students' strengths.

        Ferioli also recommends that consulting professionals should know not only how to educate children with disabilities but also how to advise teachers and parents in their tasks, and how to help professionals and parents find their own solutions to common problems so they can become less dependent on the specialist.

        Ferioli indicates that, due to social and cultural values, it is usually women who take on all responsibility for looking after the care and education of children with disabilities.  This generally means the mother works with their child every day, with some support from grandmothers, aunts, or other female relatives.  This can have a grand impact on interpersonal relationships.  Some families result in divorce.

        One of Ferioli's concluding recommendations is that the government, parent organizations, non-government organizations, and the mass media need to offer to the public simple, clear, precise information about opportunities for education and rehabilitation for this population and about the resources and programs available to them.

        SEE ALSO the Argentina resource listing further below.

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Bolivia
        Services for deafblind children are available in Bolivia.  Both the Christian Blind Mission International (CBMI) and Sense International have been involved with programs in Bolivia.  In addition, one of my contacts at Mobility International USA informs me that Bolivia has been working on forming a
group of internationally accredited sign language interpreters.

        SEE ALSO the entry for Sense International, and the entry for CBMI, under "Other Resources" further below.

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Ecuador
        Reportedly, some of the deaf children in Ecuador do have other disabilities.  One organization, called Servants in Faith and Technology, has programs that provide day care programs for children who live in poverty.  I was referred to a contact in Ecuador who is more intimately familiar with this program but, as of this writing, I have not received a reply.

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Guatemala
        A contact at Mobility International USA tells me that there is a program for children who are deafblind or who have multiple disabilities in Medellin, Guatemala.  Unfortunately, there was not sufficient time to obtain more details about this program directly from the director.

        SEE ALSO the Guatemala resource listing further below for the email address to reach the director of the program in Guatemala.

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Nicaragua
        My contact in Nicaragua runs a school for deaf children.  He reports that deaf students with additional disabilities are relatively common in Nicaragua and elsewhere because, in the aftermath of meningitis and other common causes of disabilities, the child may often acquire learning disabilities or other disabilities in addition to their hearing loss.  For example, the child may have a learning disability that results in poor abstract thought processes, or that may leave him or her with excellent language skills but with poor "or even abysmal" math skills."  Some of the other common causes of disabilities in Nicaragua include malnutrition, starvation, lack of prenatal care, and the lack of medical care in general.  My Nicaraguan contact blames the U.S. economic embargo imposed during President Reagan's administration for some cases of disabilities: the economic embargo limited access to safer forms of antibiotics in Nicaragua, which forced doctors to prescribe alternate antibiotics that carried a higher risk of causing deafness.

        There is little or no formal process for diagnosing children with disabilities in Nicaragua.  Reportedly, "Parents notice that their child is deaf and whatever.  Maybe at some point the child is brought to a health care worker who says, 'Yep, kid seems deaf and whatever.'"

        In cases of deaf children with learning disabilities in Nicaragua, the child is usually "treated as Deaf and sent to Deaf schools," says my contact.  However, in the case of a deaf child who has mental retardation, my contact asks rhetorically, "Should that child be put in a deaf school or into a program for retarded children?"  His conclusion: "That is a judgment call and depends on the level of retardation.  In Nicaragua, depending upon where you are, available services can be so lacking that one has to wonder if it really matters.  However, in those places where there are functioning schools for Deaf, as opposed to classes that really do not amount to more than daycare holding facilities, deaf children who are minimally retarded and not especially disruptive are generally enrolled.  In Bluefields (about which I can speak with certainty), the Deaf school lacks the resources for a specialized program for retarded students.  Therefore, such students would be viewed as a drain on minimal resources and therefore would be excluded.  Instead, retarded deaf children end up in a program for retarded hearing students, or without treatment altogether.  We do have a deaf retarded adult at the Deaf school.  He is permitted to attend because he is not disruptive and he carries water for us.  He derives no educational benefit at all, however."

        In elaborating upon his comments on students with mental retardation, my contact indicated, "It is not a question of schools not wanting deaf children who are severely retarded.  There are three very valid reasons for keeping them out:  1) The cost of addressing the needs of one severely retarded student in any productive way exceeds the combined cost of the rest of the student population.  2)  Unless the school sets up a school within the school -- essentially an entirely different school -- then the retarded child will receive no benefit anyway.  Are you imagining a school building with corridors and bathrooms and multiple classrooms?  And cafeterias, and a gym?  If so, you have the wrong picture.  3)  In Bluefields (but elsewhere too, I should think), Deaf students resent being lumped together with retarded children.  Deaf children and adults have enough problems getting hearing people to treat them with respect as it is.  If they are viewed as part of the retarded group, they just get stereotyped."

        Although there are deafblind individuals in Nicaragua, there are few programs or services for them.  The Asociación Nacional de Sordos de Nicaragua (ANSNIC, the National Association of the Deaf of Nicaragua) does provide some services for them in Managua and reportedly would welcome technical assistance in their work. I found their email address via the web and attempted to obtain more detail from them directly; unfortunately, they have not yet replied as of this writing.

        The nature and severity of additional disabilities, and the person's gender, are both important factors that influence adulthood lives.  Deaf females with mental retardation, for example, are often kept at home in an attempt to protect them from pregnancy.  They are, nevertheless, still highly vulnerable to rape.  Reportedly, they are sometimes sterilized after the first pregnancy.  It is difficult to obtain a legal abortion in Nicaragua because it is a Catholic country, but the courts do sometimes order one in "egregious circumstances."  Unemployment in some parts of Nicaragua is already between 60 and 85 percent for the general, non disabled population.  Both hearing males and deaf males, with or without additional disabilities, reportedly "tend to spend a great deal of time on the street doing more or less nothing" if they are among the unemployed; alcoholism is also "pervasive" among unemployed males regardless of hearing status or disability status.  My contact in Nicaragua does, however, know of some Deaf people with borderline mental retardation who "work fairly steadily doing odd menial tasks--washing taxis, pushing carts of lumber or cow carcasses."

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Other Latin American and Caribbean Countries
        Follow some of the links to the international resources listed under "Other Resources" further below to find more information on organizations, services, and programs that might be of interest to other Latin American and Caribbean countries.  Sense International, Perkins School for the Blind, and Christian Blind Mission, for example, all have programs working with deafblind people throughout the world and may also be willing to expand their programs into new countries.  Also, don't overlook opportunities to network with other people who share your interests in educating deaf children with additional disabilities in developing countries via listservers such as deafintl or PRD-L, both of which are listed under "Other Resources."

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Argentina
Graciela Ferioli, who wrote the masters thesis that I summarized above in the section on Argentina and the Southern Cone, can be reached by email at hperkins@infovia.com.ar  Her thesis, which was sent to me as a file attachment in Word document format, is 43 pages long including the title page and references.   Ferioli is also associated with the Perkins School program (see "Other Resources" further below.)

I did not have time to review it for this project, but there is a law in Argentina relating to the education of children with disabilities.  Information on law 24901 is available on the web (in Spanish).

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Bolivia
See both the entry for Christian Blind Mission and the entry for Sense International in "Other Resources" below.

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Bulgaria
See the entry for Central and Eastern European Resource Center in "Other Resources" below.

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Brazil
See Sense International in "Other Resources" below.

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Cameroon
Mr. Ondoua AbahÊGabriel is the President of the Union des Associations et Institutions des Personnes Handicapés du Cameroon (UNAPHAC).  He can be reached by email at: facaph2002@yahoo.fr

Mr. Ebot Ntui Ogork is Executive President of the Cameroon Deaf Empowerment Organization and can be reached by email at: cdeoocrs@yahoo.fr

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China
See Perkins School for the Blind in "Other Resources" below.

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Colombia
See Sense International in "Other Resources" below.

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Croatia
The Croatia Association of Deafblind Persons has a web site.

Also, see both the entry for the Central and Eastern European Resource Centre and the entry for Sense International in "Other Resources" below.

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Czech Republic
See the entry for Central and Eastern European Resource Center in "Other Resources" below.

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Fiji
The Hilton Special School has children with a wide range of disabilities, including deaf children who have additional disabilities such as cerebral palsy.  They do not have email or a web site, but their contact information is:  P.O. Box 1152, Suva. Phone - 679-3312210.

The Gospel School for the Deaf apparently might not have children who have additional disabilities besides deafness.  They can be reached at:
P.O. Box 3735, Samabula, Suva, Fiji Islands, or by email at: gosdeafsch@connect.com.fj

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Guatemala
There is reportedly a program in Medellin, Guatemala, for children who are deafblind or who otherwise have multiple disabilities.  The director, Luz Elena, can be reached by email at: multis@epm.net.co

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India
See Sense International in "Other Resources" below.

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Jordan
The Holy Land Institute for the Deaf (HLID) has a small unit for deafblind students within their program for deaf students generally.  They can be reached by email at  HLID@go.com.jo  Their administrator is Matthew Hanning; the director is Brother Andrew.  HLID does not have a web site, but I was informed that a web search for "Holy Land Institute for the Deaf" should turn up a number of articles that donors have written about their program.

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Kenya
The Kabarnet School for the deafblind is located in Baringo District, Rift Valley Province.  They can be reached by email at  mrdeaf@hotmail.com

Other schools (for which I do not have direct contact information) include the Maseno School for Deaf Blind in Kisumu District, Nyanza Province, and the Kwale School for the Deaf Blind in Kwale District in Coast Province.  Schools for deaf children in general do also accept deaf children who have physical disabilities.  Some deaf schools include: the Njia Special Unit, which is just outside Maua in the Meru North District in Eastern Province; the Kaaga School for the Deaf, in Meru Central in Eastern Province; the Kambuu School for the Deaf, within primary and secondary schools in the Thika District in Central Province; and the Kibarani School for the Deaf in the Kilifi District in Coast Province.  There are a total of 34 primary schools or units and two secondary schools in Kenya that provide education to deaf children.  There are also reportedly two colleges, but my contact in Kenya was unable to obtain their names or contact information in time for the completion of this class project.  Two organizations advocate for deaf education in Kenya: the Kenya National Association of the Deaf (KNAD) and the Kenya Institute of Special Education (KISE).

Paul Lindoewood, at the Disabled Children's Center in Kenya, can be reached by email at linmaua@maf.or.ke

Kirk VanGilder has a web page with pictures of his missionary and other travels abroad in Kenya, Turkey, and elsewhere.
http://homepage.mac.com/kirker

Njeru Muchiri, a Kenyan educator who founded the Njia School in 1990, presented a paper in Manchester, England, about his work at the Disabled Children's' Centre in Kenya.  An abstract of his paper is available on the web.
http://www.isec2000.org.uk/abstracts/papers_r/robertson.htm

Some articles about the Njia School are also available on the web:
http://www.bwconf.org/BWC_News/UMConnection/2000/Oct4-00issue/stevenscomm10-4-00.html
http://gbgm-umc.org/nwo/99ma/kenya.html  (This article has a much longer version if you get in a library that has a text version of it.)

In addition to the above, it was suggested to me that a google.com keyword search on educator "Paul Lindoewood" or educator "Njeru" should turn up further information.

Also, see the entry for Sense International in "Other Resources" below.

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Malawi
The Embangweni School for hard of hearing children has a web site
http://www.embangweni.com

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Malaysia
Jessica Mak W.E. is Programme Coordinator (Deaf Work) at the Pusat Majudiri Y for the Deaf.  The PMY can be reached at:

Pusat Majudiri Y for the Deaf
95 Jalan Padang Belia,
Off Jalan Tun Sambanthan,
50470 Kuala Lumpur, MALAYSIA
Phone: 603-2274 1439
Fax:ÊÊÊÊÊ603-2274 0559
Mobile: 013-390 2300 (SMS only)
Email:ÊÊpmy_prog@ymcakl.com
URL:   http://www.ymcakl.com/pmy

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Peru
See the entry for Sense International in "Other Resources" below.

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Romania
See the entry for the Central and Eastern European Resource Centre and the entry for Sense International in "Other Resources" below.

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Russia
See the entries for the Central and Eastern European Resource Centre, Perkins School for the Blind, and Sense International in "Other Resources" below.

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Slovakia
See the entry for the Central and Eastern European Resource Centre in "Other Resources" below.

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Tanzania
See the entry for Sense International in "Other Resources" below.

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Thailand
See entry for Perkins School for the Blind in "Other Resources" below.

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Uganda
The Uganda Association for the Deaf can be contacted by email at unad@infocom.co.ug

Joseph Mbulamwana has submitted an article from the Uganda Association for the Deaf to the International Deaf Children's Society (IDCS) that contains further information about deaf education in Uganda.  This article will be published on their web site later this year.

Also see the entry for Sense International in "Other Resources" below.

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Other Resources

       International Organizations
The Central and Eastern European Resource Center has information on their web site about schools, educational programs, and other services for deafblind children in Bulgaria, Croatia, the Czech Republic, Romania, Russia, and Slovakia.

Christian Blind Mission International (CBMI) works with people with disabilities in more than 100 countries throughout Africa, Latin America, the Middle East, and Asia.  Their focus is on blind people, but they also support programs targeted at people with multiple disabilities, including deaf people with various additional disabilities.

The Deaf Africa Fund does not have a web site.  However, Doreen E. Woodford can be reached by email at Dewdaf@aol.com

The Enabling Education Network has many resources and publications related to educating children with disabilities in developing countries on their web site at http://www.eenet.org.uk/theory_practice/theory_practice.shtml

The International Deaf Children's Society (IDCS) has information on their web site about deaf education in countries around the world.  Later this year (2004), they will be launching a new web site to "encourage the exchange of information and sharing of knowledge between young deaf people, parents, and professionals working in the field of deafness."  Their web site will publish articles compiled into a "library of information on good practice approaches to working in the specific sector of deafness."  IDCS has been specifically soliciting articles on education for deaf children with additional disabilities in developing nations for their web site.  They will continue to accept article submissions through March 5, 2004.

Mobility International USA works to promote international exchange and travel opportunities for people with disabilities and has many contacts with disability-run and disability-oriented organizations in dozens of developing countries around the world, including many that work to advocate for the rights of children with disabilities to have access to an education.

In addition to their domestic program in Watertown, Massachusetts, in the United States, the Perkins School for the Blind also works to promote improved education for blind children in developing countries, including deafblind children with or without further additional disabilities.  They work in more than 50 countries around the world.  Some of their activities have included providing consultation services and training to teachers who work with children with multiple disabilities in developing countries.  Perkins has a range of education-related publications.  In addition, they offer a nine-month course, called the Educational Leadership Program, for teachers and special educators who work with blind or deafblind infants, preschoolers, and school-aged children.  The Perkins School has programs in Eastern Europe, Latin America, the Asian/Pacific region, and Africa and the Caribbean.  They also have regional offices in Thailand and in Argentina.

Sense International offers a Professional Development Program for professionals throughout the world who work with deafblind children in developing countries.  The initial training program is six weeks long, located in the UK, with a one-year follow-up program after the professional returns home.  Many of their graduates have established new programs for deafblind students in developing countries--sometimes the first, or nearly the first, of its kind in their country.  Sense International has been involved in the Central and Eastern Europe, Africa, Latin America, Romania, and India.  They have on-line publications and other resources.  Publications in Spanish are available from their program in Latin America.
 

        Listservers and Other Resources
The Deaf Empowerment and Advancement Fellowship INTernational Listserver (deafintl) is a FREE email-based network for deaf people in developing countries and other interested individuals.  Participants are able to use deafintl to exchange news, information, advice, resources, and ideas related to facilitating the self-empowerment of deaf communities in developing countries.  One of the many topics that is warmly welcome on deafintl is discussion on how to improve access to education for deaf children with additional disabilities in developing countries.  Individuals who are not interested in subscribing to deafintl at this time may still read old deafintl posts via the online archives; a link to the deafintl archives is provided at the main deafintl web site.

The Poverty Reduction and Disability Listserver (PRD-L) is another FREE email-based discussion group devoted to the discussion of poverty reduction for people with disabilities in developing countries.  Although PRD-L is not specifically focused on education, discussions related to this field can sometimes emerge on PRD-L because education is often a crucial component of poverty-reduction efforts in developing countries.  Individuals may subscribe via the web, or may contact the listowner, Patrick Burke, at burke@ucla.edu

The World Bank has a document, in PDF format, on inclusive education in developing countries.  WARNING: THIS DOCUMENT IS MORE THAN 100 PAGES LONG.  It will take a while to download.  .

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