ALL children, including children with disabilities, have the right to live with and be cared for by their parents. In cases where the immediate family is unable to care for a child with disability, the Convention on the Rights of Persons with Disabilities requires governments to “undertake every effort to provide alternative care within the wider family, and failing that, within the community in a family setting”.
The Convention on the Rights of the Child calls on state parties to establish programmes to de-institutionalise children, including those with disabilities and return them to their biological or extended families, place them in foster care, and introduce “family- and community-based solutions”.
The findings of the Mendez Report on Torture stress that institutional settings are intrinsically dangerous and inherently discriminatory, incarcerating people against their will and dehumanising them through subjection, cruelty and regimentation. They have called for all governments to shift to family and community-based settings to improve the quality of life of these individuals.
However, the costs of de-institutionalisation are prohibitive and even resource-rich countries find it difficult to rehabilitate children with disabilities in line with Articles 14 of the CRPD and 21 of the CRC. De-institutionalisation can even lead to misuse and manipulation if it is not supported by well-thought-out strategies and funding structures.
The conditions in custodial settings are terrible in Pakistan.
In Australia, community services are lagging far behind the process of de-institutionalisation, while in Canada, the reduction of funding for residential institutions and psychiatric hospitals has led to an increased number of persons with disabilities in prisons. “At each step of the way, de-institutionalisation acted as a doorway to re-institutionalisation in the prison system for people who didn’t fit or were ‘unfit’.”
Under the Daphne Programme for Justice, EU governments are now rehabilitating children and adults in family- and community-based arrangements wherever possible, in compliance with UN conventions and the even more stringent European convention.
Transitioning persons with intellectual disabilities to alternate settings requires designing new systems of care such as safe housing and shared living accommodation within communities, and services including therapeutic interventions, education, transport and sheltered employment, all of which require hefty government funding.
While foster care is the most preferred alternative to institutionalisation, it can only take place in very privileged settings with strong social systems, till the child can be unified with his own biological or extended family or adopted after proper screening of potential caregivers. Other best practices include Mother & Baby Units within institutional settings to support single mothers who would otherwise have abandoned their children.
The US has had group homes in place for at least two decades, while social services are excellent in some states. Generally, improved monitoring and accountability systems have been put in place in institutions, intensive training and sensitisation of health workers, mental health professionals and staff on the rights and needs of children introduced, and additional laws to protect children enacted.
In South America, Africa and Asia, very little attention is paid to children once institutionalised. Lack of funds should not be an excuse to continue with inhumane practices; these issues should be prioritised by governments.
It is incumbent upon governments to develop holistic policies and programmes to rehabilitate people and introduce services such as free healthcare, inclusive schools, community daycare centres for smaller children, parent counselling and training, respite care and financial assistance to families of children with disabilities.
In Pakistan, the conditions prevailing in custodial settings are terrible. The families of destitute children do not come back to claim them and, in the absence of alternative care or rehabilitation policies, they are left at the mercy of the staff. Then there are thousands of children in adult prisons, many of them suffering from undiagnosed intellectual disabilities. The number of juvenile detention centres and borstals in the country is abysmally low compared to requirements.
There has been no official response, no administrative policy or strategy concerning torture in our custodial institutions post-Mendez. The government ostensibly lacks funds for any social sector overhaul.
Nevertheless, it must engage with civil society for an intensive dialogue on this issue, set up task forces in cities to develop alternatives, provide training to local governments, and establish pilot rehabilitation centres within communities for a start. It must also initiate reforms by introducing strong monitoring mechanisms in existing institutions, ensure stringent accountability of administrative staff, and take exemplary punitive action against all offenders.
The writer is a former federal secretary.
Published in Dawn, May 15th, 2017