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RAVICHANDRA RAJU

India,

Ravichandra Raju (Ravi), a trained social worker, provides poor families with access to technology for disability assistance and rehabilitation.

This profile below was prepared when Ravichandra Raju was elected to the Ashoka Fellowship in 2002.

INTRODUCTION

Ravichandra Raju (Ravi), a trained social worker, provides poor families with access to technology for disability assistance and rehabilitation.




THE NEW IDEA

Ravi has integrated the role of family and community members in the provision of appropriate services to disabled people. In India, citizen sector organizations and companies have offered aid to poor people with special needs but have not fully optimized these peoples' particular living situations. Ravi, however, draws on the experience of people living with disabled people to design more effective aids. By helping establish relationships between physical aid manufacturers, service providers, handicapped people, and community members, he maximizes efficiency, prepares young people for careers in rehabilitative services, and helps in the process of social integration. Moreover, Ravi's approach, which facilitates more direct contact with disabled people and their families, increases professionals' capacity to provide counseling, technical service, and more effective technology.




THE PROBLEM

According to the National Sample Survey of India, nearly 2 percent of the total population suffer from severe or profound disabilities. Furthermore, 12 percent of those have multiple disabilities. According to the Artificial Limb Manufacturing Center fact sheet, about 4.5 million people require mobility appliances but only 5 percent of that number receive the required aids. The population is mostly unaware of the usefulness of mobility devices.

The disabled are denied opportunities for personal advancement beginning at a very early age. Children with cerebral palsy, locomotion disability, and developmental delay are largely confined to their homes or lodged in homes for the disabled. A survey of 6,500 students attending special child laborer schools run by the government of Andhra Pradesh found that about 11 percent needed, but did not receive, immediate medical attention to prevent lifelong disabilities.

At present, the government of India spends 40 to 50 rupees per disabled person each year for assistance devices. Because this allowance is insufficient, most people must purchase their own aids. Moreover, rehabilitative and handicap-support technology is expensive and not readily available, causing many disabled people to use inappropriate devices or nothing at all. The problem is compounded by the shortage of expert technicians and most profoundly affects the poor and children whose needs are not clearly defined.

There are currently few efforts underway by the key stakeholders in curative and disabled support services. Most devices are developed for market impact, leading to limited community access. Although the Rehabilitation Council of India recognizes seven national-level institutions offering certificate, diploma, or degree courses in orthotic and prosthetic engineering–graduating about 100 people every year–new engineers are lured away by attractive jobs in the West and rarely remain in India. In short, existing systems and organizations are not reaching those people most urgently in need of assistance.




THE STRATEGY

Ravi's investigation shows that the families of children with severe handicaps offer certain expertise in diagnosis and treatment of most cases and lend an accountability and efficiency to the field of aid technology and therapy that is desperately lacking. In addition to involving relatives in the design of assistance devices and services, he advocates a movement toward localized construction of devices, enabling community members, particularly youth, to be trained as semiprofessional engineers and technicians. More local manufacturing promotes the delivery of case-appropriate technology, increases community buy-in, facilitates social integration of disabled people, sustains impact on the communities with the greatest need, preserves historical knowledge between generations, and leads to cost-effectiveness for producers in the long run.

While working at the Institute for the Mentally Retarded, Ravi always questioned himself about why families were kept out of all therapeutic activities. The practice led him to develop a program titled Parents Independent Support Group. Interactions among parents of the disabled in group sessions and home visits during therapeutic activities helped them to unleash their own imaginations to support the children in a meaningful manner. "The whole experience gave me the insight about the richness of parents' capacity to understand the child's situation and the capacities of the family," Ravi recalls, "but when I proposed to expand the program, the other practitioners and the management were not prepared for it."

In 1994, based on his earlier model of a parents' group, Ravi founded the Mana Center, to evaluate objectively the positive and negative effects of family- and community-centric intervention in the treatment of children with disabilities. The center hosts weekly two- to three-hour workshops for relatives and neighbors of handicapped children based on years of holistic research and practical application of new theories. A staff physiologist works with the people who have the most contact with disabled children in the community to design and construct physical aids, develop treatment plans, and become qualified, semiprofessional service technicians.

To supplement these workshops and meet the increasing demand for similar services, Ravi created a four-month course through which students not only prepare to treat their handicapped relatives or neighbors, but also become trainers able to conduct similar courses for people living with disabled or at-risk children. After completing the course, these trained professionals plan and implement strategies for their own communities and, in some cases, launch satellite Mana Centers in other underserved areas. These family educators are now the leading advocates for technology transfer, visiting different cities around India and spreading Ravi's mission to accurately assess and meet the needs of all disabled people.

Over the past seven years, Ravi has conducted approximately 70 workshops and more than 100 training programs, thereby affecting some 500 family and community members and 2,500 disabled people. Moreover, unlike other workshops on the topic of special needs treatment, the supposed indirect beneficiaries–handicapped children–actually take part, testing and offering input on each new plan and design. With his hands-on, bottom-up approach, Ravi's model guarantees that the best services reach the neediest people in the shortest possible time and with the greatest potential for spread.

Ravi focused his first projects on the slums of Hyderabad and other areas of Andhra Pradesh, a southern state of India. Success has led to early discussions with the Andhra Pradesh Department of Disabilities, the District Rehabilitation Center of the Government of India, and various citizen sector organizations in the region about placing formal emphasis on the role of family and community members in the delivery of aid to disabled people. Ravi achieves greater outreach through various speaking engagements, publications, and appearances at conventions. He is also working with philanthropists and stakeholders in the industry of therapeutic and handicap-support tools–both to increase technology transfer and access to credit to the most needy people and to invest in case-specificity and localization aimed at greater efficiency and accountability.




THE PERSON

Ravi spent his childhood in the underdeveloped Indian states of Karnataka and Andhra Pradesh. He traveled around the country with his father, an employee of the ever-expanding Indian Railways, observing both the utility and shortcomings of the intersection between humanity and technology. Ravi became a National Service Scheme (NSS) volunteer, organized various students' forums within his faculty, and went on to study the arts. After his father's untimely death, Ravi's mother took a job as women's coordinator at a citizen organization in Andhra Pradesh to support her family. His mother's efforts left a distinct impression on Ravi, demonstrating that the people of poor communities–not the projects–are the real development base. While studying for a master's degree in social work, Ravi completed fieldwork and learned sign language at the Child Guidance Clinic and the Institute for the Deaf and Dumb.

After a short stint working in the personnel department of the Singhrani Coal Mines, Ravi returned to development in 1992 as an officer for the Promotion of Indian Adoption. His full association with the field of disability assistance began in 1993 at the Institute for the Mentally Retarded where he worked with 12 families and unsuccessfully proposed a programwide evaluation of the role of parents in disability care. Recognizing the untapped capacity of families in the rehabilitation and support of disabled children, he left the institute in 1994 to found the Mana Center.




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