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From the speech by President of College of Ophthalmologists of Sri Lanka Dr. Champa Banagala at the 12th Annual Scientific Sessions of the College of Ophthalmologists held at Colombo Plaza recently.

It is with great pride and pleasure that I stand here today to deliver the presidential address, as the 12th President of the College of Ophthalmologists of Sri Lanka. Let me once again welcome you very warmly and thank you for being here. Your presence today is a great source of encouragement to me.

In my address today, I would like to review the present system of education and rehabilitation of the Blind and Partially Sighted in Sri Lanka, while offering some suggestions for its improvement. I hope I would be permitted to make some constructive criticism as well in this regard.

Knowledge of the physical world around us is obtained through our senses. Vision is the most precious and vital sensation we experience. Human society has, from time immemorial valued eyes and sight, assigning them a special place in art, philosophy, religion and culture. Through song, poetry and drama, eyes and sight have been much acclaimed.

The loss of sight is one of the greatest misfortunes that can befall a human being. While each person's blindness is his own individual predicament, blindness is more than a personal tragedy. It is in fact one of the commonest causes of social dependency with profound human and socio-economic loss. Further, the life expectancy of blind persons is one third less than that of their sighted peers, and, most of them die within ten years of becoming blind.

I thought it may be useful to spend a few minutes to tell you very briefly about the magnitude of blindness in the world and its causes before I deal with the situation in our country.

There are estimated 180 million visually disabled people in the world. 45 Million of them are totally blind and cannot move around without assistance.

This is equivalent to one individual going blind every 5 seconds! As Blindness is intimately related to aging, 80% of blindness occurs among the elderly.

There are estimated 1.5 million visually disabled children in the world. This number may appear to be small when compared with that of blind adults. But when calculated by the number of blind years (that is, the number of years one spends as a blind person) it is a substantial number, specially when an average life expectancy is considered.

With regard to the causes of blindness, cataract takes the first place, followed by Trachoma, Vitamin A deficiency and river blindness or Onchocerciasis. Glaucoma and Diabetic Retinopathy are additional causes leading to blindness in the world. In our country too the main cause of visual disability is cataract; followed by Glaucoma, Diabetic Retinopathy, Trauma and Macular Degeneration. Hereditary and perinatal causes are common reasons for visual disability among children.

Visual disability is mostly prevalent in developing countries where added pressures of poverty, lack of education and lack of medical care worsens the problems. It is very sad to note that most of the visual disabilities due to causes mentioned above could have been well prevented.

The numbers I gave you earlier will be useful in depicting a statistical picture of global visual disability. However, numbers do not narrate the whole story; they only depict a part of the problem!

From the global picture of visual disability let us now move on to the Sri Lankan situation. Here we do not have recent national figures related to blindness. It is believed that the number of blind people in Sri Lanka is around one hundred thousand. This is just a rough estimate which only indicates the order of magnitude of the problem. Also considering the global figures there is an estimated 2500 blind children and thrice that number who are visually disabled in the country.

With this background Your Excellency, and Ladies and Gentlemen let me now come to the main theme of my presentation - Review of Education and Rehabilitation of the blind and partially sighted in Sri Lanka.

We have a long and reasonably successful history of educating the blind in the country. The first school for the blind was established in 1912 in Ratmalana, almost five decades before formulating a national policy on disability. The founder of the school was a British Anglican missionary. At present there are 178 visually disabled children enroled in this school. Fourteen more similar schools are now functioning throughout the country.

We should be thankful to those pioneers and the management for services rendered. The Code of Regulation for Special Schools was first published in 1929 which gave the teacher to student ratio as 1:10.

A significant change in educating visually disabled children took place in 1969 with the introduction of integrated education for the disabled and the enrolment of 17 visually impaired students into mainstream government schools. Integrated education provides the opportunity for disabled children to be in a normal school environment, and yet carry out their academic work in an exclusive classroom meant only for them.

In 1971 the Special Education Unit was established at the Ministry of Education, which is now the "Department of Non Formal and Special Education".

An amendment to the code of Regulation for Special Schools was introduced in 1986. By this the number of students per special teacher was reduced from 10 to 05 with the aim of providing a better quality education. A special circular issued by the Education Ministry in 1992 clearly states how children with special needs are to be identified.

A new chapter in educating disabled children came into effect in June 1994 when Sri Lanka together with 91 other Governments and 25 international organizations placed their signatures to the well-known "Salamanca Statement". They agreed on a dynamic new statement on the education of all disabled children, which called for "inclusion" to be the norm. They also developed a new framework of action to guide principals of normal schools in the matter of accommodating children regardless of their physical, intellectual, social, emotional, linguistic or other conditions. This also enunciated rights and privileges of disabled children.

In 1999, the Ministry of Social Welfare in a document "Compilation of a national policy on disability" reviewed the situation regarding special education in Sri Lanka. The document touched upon several matters including the need to establish a proper procedure to be followed in identifying the children with special needs, and their entry to normal schools whenever possible, and also the need to train teachers to handle children with special needs.

Further, the Ministry of Education in its circular issued in May, 2001 has instructed the relevant authorities to give all possible assistance to the children with special needs in every instance including examinations. The Ministry of Education has already commenced a comprehensive 3 year training programme at the College of Education Hapitigama to train teachers in Special Education.

"Inclusive education" means peers in the same classroom educating disabled children with their normal environment. Educating children together in a normal environment help both parties to learn from each other and lend a hand to friends as required. Further, normal children would then learn to appreciate the special skills of their so-called disabled friends.

This arrangement would also help to smoothly integrate the visually disabled with mainstream society. After all, acceptance of visually disabled into mainstream society should start from the school and permeate into the larger society gradually. This is turn will facilitate the process of absorbing them into the regular workforce of the country and place them in positions they deserve, where their skills and talents could be harnessed to the maximum.

Changing from one system to another has to be done most carefully specially in the field of education. At this point may I make a few suggestions with regard to improving the present education system for the visually disabled children in Sri Lanka. Firstly we should make better use of facilities already existing, using the present network of schools for the blind as homes for the children where special facilities needed for them are already available.

Whereever possible a neighbouring school or schools should be provided with special teachers and other necessary resources to accommodate visually disabled children. Some of the teachers with the necessary qualifications presently working in special schools can be transferred to the selected mainstream schools.

Having someone they already know in the mainstream school, someone familiar with their needs and problems, would undoubtedly reduce the childrens feelings of fear and anxiety as they enter new unknown territory. This should be carried out as a pilot project centred around the Ratmalana Special School for the Blind with their help first. Once we gather experience and convince ourselves with regard to its feasibility it could be implemented as a national project. One may encounter many drawbacks and disappointments. However, by understanding our strengths, weaknesses and also learning from our mistakes we should be able to implement this scheme successfully and reap its benefits.

In June 2003, The College of Ophthalmologists with the Ministry of Health and Sight Savers International UK started a fresh study to assess visual disability of Children of Schools for the Blind and the causes of their disability. This project which is coordinated by me as the President of the College has covered all Schools for the Blind in the island and all the normal schools with visually disabled children. We hope to produce the final report by December 2003.

The Ministry of Education is organizing a seminar in November 2003 to review the present education system for the disabled. This will be followed by another seminar organized by the Ministry of Health on childhood blindness. We hope that together with the Ministry of Social Welfare we will be able to make recommendation to improve the education of the visually disabled in the country.

So far we have discussed as to how to include visually disabled children within the mainstream society. At this point it will be relevant to consider how we can address the same problem in relation to adults who are in a similar plight.

To my knowledge there is no proper register of blind adults in our country who have been examined by Ophthalmologists and given a proper diagnosis. I am sure many low vision people also would have been classified as blind as in the case of children. The first and foremost need today with regard to the adult visually disabled is to have a proper register of adults with the correct diagnosis and level of visual disability certified by an Ophthalmologist. The Department of Social Services together with relevant non governmental organizations should take over the blind person from this point and place him or her at a suitable position as recommended by the Ophthalmologist. If necessary follow up should be done by the Ophthalmologist.

Experience has shown that Visually disabled and for that matter persons with any other disability could be converted to very productive individuals who can contribute equally towards national development as others.

As I mentioned at the very outset of this address, we perceive the physical world around us through our five senses. Almost everything around us has been created by us to make our life easy and comfortable.

What I meant by "us" is the normal people without any disability whatsoever. In creating this environment we have almost forgotten if not totally forgotten the disabled. Be it education, art, drama, music or any other man-made activity, it has been designed for the benefit of the able bodied. Such a world is really a difficult one for the disabled, especially for those who are visually disabled.

If a disabled person achieves something however small, I consider it a great achievement because he or she is working in a world which is designed for those who can interact with the world with all five senses. It is heartening to note that there are many disabled including visually disabled who have achieved levels that are significantly above what their able bodied peers have achieved. One such disabled person who reached the zenith in the world of science is Professor Steven Hawkins who is presently holding the Chair for Theoretical Physics, at University of Cambridge a position once held by Sir Isaac Newton.

If we consider our own country, the present Professor of Western Classics of the University of Peradeniya is a visually disabled person. In addition there is a host of visually disabled artists, musicians and others who can boast of very successful professional careers. We should not forget that all of them are performing extremely well in a domain which is not meant for them and sometimes even hostile to them. If a disabled person can be successful in an environment of this nature he or she should have extraordinary skills, superb ability to focus attention and marvellous resilience. We should recognize them as a pool of resources that could be put in good use for the benefit of the larger society and certainly not treat them as a liability.

At this point it is worthwhile to ponder on how normal society feels towards the visually disabled and what the visually disabled expect from society.

Normally most of us feel sorry for the plight of the blind people and are Sympathy prepared assist them in whatever way we can, is something that arises purely due to kindness, kindness towards a person or persons who are not as fortune as we are. It is often associated with patronizing attitudes. I am positive that this is not what is desired by the disabled in modern society.

Their greatest wish is to have the respect and recognition of society and be accepted as an integral part of that society with the same rights and privileges as enjoyed by the others. The following statement by Sir John Wall, CBE of Royal National Institute of the Blind amply illustrates the wish of the visually disabled in the new millennium.

"No difference from those of the sighted. They want a happy childhood, a good education, a satisfying job, a fulfilling family life, enjoyable leisure and social activities, and the chance to take a full part in public life. They want respect, esteem, affection, but above all recognition that they are citizens with full civil and human rights."

Though in a different style and language, I am sure any visually disabled person in Sri Lanka or any other part of the world would express the same sentiments as Sir John Wall since aspirations and expectations of all visually impaired people are the same despite cultural and other differences.

How far have we Sri Lankans gone in safeguarding rights and privileges of the disabled? The first piece of legislation in this regard was introduced in 1966 with the "Protection of the Rights of Persons with Disabilities Act", No. 28 of 1996. It very clearly states that no person shall be discriminated against on the grounds of any disability, in recruitment for any employment or admission to any educational institution.

It also gives guidelines on how to act in case of any injustice and action to be taken for relief or redress. Nearly one month ago in August this year an amendment has been passed to this Act which seeks to enhance and expand public facilities for the disabled.

As far as legislation is concerned we can be proud that we are not lagging behind the international community. The question remains however as to how many of these laws are being practically implemented.

How can we help the visually disabled to attain their legitimate place in society?

Firstly, we have to convince ourselves that the visually disabled are also entitled to the same rights and privileges as we have and try and transform our sympathy into respect, acceptance and recognition.

This is not an easy task that can be achieved overnight. This involves an attitudinal change of society with the help and blessings of society. We Ophthalmologists are prepared to work hand in hand with other relevant groups such as social workers, non government organizations, media personnel and artists to bring about this vital attitudinal change in our society.

In my presentation I have focused attention on two aspects of visually disabled; the first is taking visually handicapped children into the mainstream of the National education system and the secondly the changing of the attitudes of the society towards the visually disabled from sympathy to recognition and acceptance.

As I explained in my presentation earlier both these tasks are certainly not easy ones; neither can they be achieved overnight.

They involve a long and arduous journey which requires enormous amount of strength and courage to continue since we can not see the destination. Let us continue this journey with hope and determination without worrying too much about the destination as journeys are invariably more interesting and also more intriguing than the destination. On that note, Your Excellency and Ladies and Gentlemen let me conclude my presidential with the hope and expectation that we together can create a new world for the blind and visually disabled and help them to realize their cherished dream.

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