Comments on the REHAB 98 Congress in Dubai
Maruja SENER
President of Association MYONET
April 1998

The United Arab Emirates organize in Dubai an International Congress on the Rehabilitation of disabled people. First took place in October 1996 on the topic "Awareness". The second has just ended this Tuesday March 31, after 3 days of exhibition and conferences.

It was the occasion to visit such a magic city, where mosques proudly draw up their minarets between ultramodern buildings decorated with neon garlands. Golds and perfumes, rich tissues along the lanes of the souk, advanced architectures and technologies. And in all that, women buckled of black, men draped of white.

Gathering delegates of Africa, Middle East and South Asia, this event is the first of the kind in the area. It represents an exceptional occasion of exchange of informations and experiments for developping countries, which also invite speakers of developed countries to present their know-how and their data.

The world politics context in which the congress prepared let plane some tensions. Traces of concerns, but also of relief, remain sensitive in the wake of the war engines which had just left the Gulf.

In the corridors during the pauses, two worlds meet. Delegates recognize themselves, to have already taken part in joint meetings, but one notices quickly two groups, that of people of the Southern countries, and that of people of Northern countries. Some attempts at communication between the two groups thake shape, with some hesitations.

Particularly touched by the problems of disabilities, because in particular of the emergence of physical and mental incapacities related to consanguin marriages, the United Arab Emirates are on the point to write laws governing the prevention of disabilities, the rehabilitation and the equalization of opportunities.

The requests of delegated other countries represented relate to the search for relevant models, the definition of local priorities, for which the government of each country have a role to play, and international priorities which imply international institutions and non-governemental organizations.

Among the delegates of the international organizations, some have models to sell, and they enter in competition the ones with the others. The interests of the various nations also diverge on other points, in particular the priorities to be defined. It remains, and it will remain a long time, of the difficulties for developed and developing countries to communicate.

The cultural prejudices are numerous in the two directions, and the emotional aspect of the subject returns the debates thrilling, and impassioned. For delegate : "In the western countries they kill their babies when they know they are disabled". For another : "In China, I did not think they knew life". And me, I did not imagine to see these buckled women, all equipped with their cellular portable telephone, chattering without complex, speaking in public and directing themselves establishments of care and education. They intervene as much as the men, directing certain debates, and their words weigh as heavy as those of men.

In spite of the divergences of interests and culture, the basic problems are obvious :

How to prevent the disabilities, in a community where finding food seems to be more important than taking a parturient at the hospital ?

How to make a place for disabled in the world of education and work ?

How to guarantee equalization of chances and social integration, when the access to transport and public places is impossible ?

Which role is one ready to give a disabled person in his own family ? Ethically, religiously, daily, how to think the sharing of life in its different forms ?

Technologically, how to return to a human its dignity, by its autonomy, its independence in day-by-day life, deplacements, work ?

To relativize the answers

The Western models are not valid just as they are in other cultures.

The taking into account of the disabilities in the arabo-muslim culture has a long and rich history, and is not easily transposable in a Western society. In particular, the integration of the disabled people is based on a concept of life community, in what it represents of sharing responsibilities and richness, in a human or material way. The disabled person is necessary to the balance of the group, socially and spiritually.

To integrate the answers

Western side, there is an experience of costs, infrastructures, statistics, technological answers, which one can transmit.

On the other side, there is a practice of integration, a different, family and community glance, on the disabled, which one can hold account.

But to understand each other, i.e. to manage to assimilate the messages of one other, it is necessary to accept a change of mentalities. In all the cases, to learn how to emit and how to receive, leads to transformation.

To take account of the results and economic realities

To take into account the whole of the individuals of a community, is the best way of giving this community live and prosperity. Several experiments show the profitability of the social integration of the differences.

Quite everywhere, private initiatives for the prevention of the disabilities exist, but their cost is prohibitory. As long as the costs are not distributed on the community (for example for the equipment of public hospitals), the disabilities are degrading and their assumption of responsibility is then much more expensive.

When buildings integrate, as of their design, the concepts of accessibility for wheelchairs, their cost is largely lower than when it is necessary to rehabilitate them after their construction. In addition, to ensure the safety of the domestic environment makes it possible to reduce a significant cause of mortality, including in the Western countries (on average 4,000 dead, 4 million serious "domestic" accidents annually in the U. K.).

Experiments of transformation of public networks, allowing the accessibility of transport and the stores for wheelchairs, showed that these transformations were economically very largely profitable. Not only disabled people consume, but "accessibility" concerns also people with baby-carriage, elder people, etc...

To find the third way

Of course, there is not an answer, but tracks to be explored. There is not a model, but particular cases. The particular case takes account of an environment, a history, a specificity.

Even North-South cleavage is reducing. There are more relevant cleavages, inside event of the countries, whatever they are. For example, in all the countries, between rich and poor (the ones will make establish a diagnosis abroad, where are the specialists, and place their children in special institutions, the others see dying their children of sometimes benign diseases).

To think that it is necessary to choose, either medical eagerness, or resignation, does not take account of all the possibilities which exist between these distinct positions. A mother testifies to long years spent to seek a therapy, even partial, for her son. Quite a million dollars on examinations, consultations, journeys abroad, search of competences, at the price of her family life, and of a peace which could not be found, finally, that in the renouncement. And another testimony, universal, of a patient which the doctors had condemned to never walk, to never speak. In her family, the message of resignation did not pass, and after daily care, she walks, she speaks, attend to congresses, she is married and mother of four healthy children.

In one of the fields which interest MYONET, which is the bringing up of disabled children, there are other ways to explore that only the choice enters the segregation, the slavery of the family, and the integration at all costs. The search for an education system where integration and respect of the differences will go from oneself, is not a Utopia. It is not either, according to the disabilities, always possible. It is a family choice, it is also a child choice. The physiological injuries are different from one to another. The intellectual and emotional needs are also different from one to another. The integration of differences in an education and social system enriches it, raises the total level of conscience and competence.


In short, I would like to go back to Dubai. I would like to see what the shared hope can give birth to. I would like to believe in it. To believe that one can contest preconceived ideas. To believe that one can take part in the creation of a new world. To believe that one can make a worthy place for our children, our beloved, our friends.

To keep only love in mind, whatever its name.

* * *

The main recommendations of the Congress :

1. To avoid as much as possible the consanguin marriages,
2. To set up laboratories which will study genetic diseases,
3. To help research against epilepsy,
4. To ask for a legislation on accessibility and security,
5. To promote public education on prevention and security (safe driving),
6. To educate doctors on spinal injuries,
7. To give an immediate support to disabled and facilitate their social integration,
8. To organize programs of general education on disabled,
9. To integrate in the studies of construction of buildings the accessibility for disabled people,
10. To adapt public transport,
11. To organize occupational training for the disabled to be useful,
12. To allow employment for 100% of their wellforce,
13. To supervise the monitoring of premature births and children of small weights,
14. To encourage the early detection of the disabilities,
15. To encourage a normal schooling for disabled children,
16. To introduce a program of monitoring of new-born and early diagnosis,
17. To integrate the special needs in the community,
18. To improve accessibility and safety of habitations,
19. To create a special stamp to sensitize the public opinion,
20. To encourage meetings between the countries of the area, and search of quantified information (statistics, data bases, ...).