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The  social  inclusion  of  

children  with  special  needs  
and  disabili4es  in  Uganda  
Children  with  special  needs  and  disabili4es  in  
Uganda  
Despite   a   favourable   policy   context   and   the   availability   of   suppor6ve   services   for   children  
with   disabili6es   in   Uganda,   the   majority   of   children   with   special   needs   do   not   enjoy   their  
rights  to  survival,  development,  protec6on  and  par6cipa6on.  Due  to  the  s6gma  associated  
with   disability,   children   are   o>en   completely   excluded   from   society,   thus   preven6ng   them  
from  accessing  any  social  interac6on.  
It  is  es6mated  that  2.5  million  children  in  Uganda  live  with  some  form  of  disability  (12%  of  
all   Ugandan   children)   and   that   only   6%   of   children   with   disabili6es   in   Uganda   complete  
primary   school   educa6on   compared   to   50-­‐75%   of   typical   children   (UNICEF).   Children   with  
disabili6es   are   among   the   most   marginalised   and   disadvantaged   groups   of   Ugandan   society.  
Children   with   special   needs   experience   mul6ple   forms   of   exclusion   including   access   to   basic  
resources  such  as  educa6on,  healthcare,  social  and  legal  support  systems.  In  addi6on,  they  
are   confronted   with   nega6ve   aNtudes   and   o>en   experience   discrimina6on,   violence   and  
abuse.  HumaneAfrica  currently  supports  a  number  of  children  with  special  needs  who  have  
been  hidden  away  from  society  and  have  had  no  social  interac6on  for  the  majority  of  their  
lives.  The  main  barrier  to  these  children  receiving  therapy,  support  services  and  educa6on  is  
the   aNtude   of   the   community,   which   results   in   families   of   children   with   special   needs,  
hiding  their  children.  

About HumaneAfrica
HumaneAfrica  is  commiRed  to  ensuring  protec6on  and  support  for  the  most  disadvantaged  
and  vulnerable  children  in  Uganda,  especially  those  living  in  extreme  poverty,  those  exposed  
to   violence   and   those   with   disabili6es.   HumaneAfrica   works   with   communi6es   in   Uganda   to  
eliminate   harmful   prac6ces   which   either   harm   or   have   a   nega6ve   impact   children.  
HumaneAfrica’s   grass-­‐roots,   social   norms   approach   ensures   that   communi6es   take  
ownership  of  their  ac6ons  towards  children  and  both  understand  the  impact  these  ac6ons  
have  on  children  and  also  find  the  solu6ons  within  their  own  communi6es  to  abandon  these  
harmful  prac6ces.  

Social inclusion of children with special needs and
disabilities
The   star6ng   point   for   social   inclusion   of   children   with   special   needs   and   disabili6es   is  
loca6ng  children  who  are  excluded  from  society.  HumaneAfrica  currently  supports  a  number  
of   children   who   have   spent   the   majority   of   their   lives   hidden   from   society.   Their   neighbours  
have  been  aware  that  the  child  exists,  but  have  never  seen  or  interacted  with  these  children.  
The   following   are   some   examples   of   children   who   have   been   excluded   from   society,   now  
supported  by  HumaneAfrica.    
Nicholas  

HumaneAfrica  first  met  Nicholas  in  May  2013  when  he  was  14  years  old.  Nicholas  had  not  
been   out   of   his   two   room   house   for   11   years,   since   his   mother   discovered   he   had  
developmental   delays.   Nicholas   spent   his   days   and  
nights  lying  in  the  same  posi6on,  with  no  s6mula6on.  
He  was  severely  malnourished  and  his  body  was  locked  
in   the   fetal   posi6on.   He   gave   no   reac6on   to   sound   or  
light.   HumaneAfrica   arranged   for   an   assessment   and  
found   that   Nicholas   had   cerebral   palsy.   An   extended  
stay   in   a   nutri6onal   centre   was   arranged   and   once  
Nicholas   was   strong   enough   he   returned   home   and  
began   physical   therapy   in   an   aRempt   to   loosen   his  
joints   so   he   could   sit   upright.   During   this   period  
HumaneAfrica   worked   with   Nicholas’   mother   to   bring  
her  to  understand  that  Nicholas  was  not  a  curse  on  her  
family,   an   opinion   imposed   on   her   from   her  
community.   HumaneAfrica   then   arranged   for   a  
wheelchair  so  Nicholas  could  safely  sit  upright  and  eat  
in   that   posi6on.   Due   to   the   lack   of   nutri6on   and  
s6mula6on   over   most   of   Nicholas’s   life,   it   will   take  
some   6me   before   the   benefits   of   the   nutri6on   and  
therapy   are   visible.   However,   Nicholas   is   now   able   to  
make  some  verbal  sounds  and  eye  contact  is  emerging.  
He  spends  a  few  hours  each  day  out  of  the  house  and  
has  physical  therapy  sessions  once  every  two  weeks.    
Nicholas’  first  day  in  his  wheelchair
Jamilah    

Jamilah  is  11  years  old  and  lives  with  her  mother  in  a  small  single-­‐roomed  house.  Her  father  
le>   with   her   two   siblings   when   Jamilah   was   2   years   old,   saying   she   was   an   outcast.   The  
family  is  extremely  poor  and  are  only  able  to  eat  when  Jamilah’s  mother  has  money.  
Jamilah  has  cerebral  palsy  and  uncoordinated  movements  which  her  mother  says  has  make  
it   difficult   for   Jamilah   to   be   outdoors   without   aRrac6ng   unwanted   aRen6on.   When  
HumaneAfrica  first  visited  Jamilah’s  house  in  October  
2014  she  was  locked  in  the  room.  HumaneAfrica  staff  
waited   for   several   hours   for   her   mother   to   return  
from  the  field  where  she  was  working,  digging  earth  
for   a   landowner.   Jamilah   was   lying   naked   on   an   old  
soiled  maRress  and  her  sporadic  movements  resulted  
in  banging  and  scraping  the  walls.  The  scratch  marks  
and  blood  from  Jamilah  arms  and  legs  were  visible  on  
the   walls.   Jamilah   was   unable   to   sit   or   support  
herself.  She  had  spent  the  majority  of  her  life  locked  
in   this   room   without   any   form   of   social   interac6on.  
Her   mother,   while   extremely   caring,   was   not  
prepared   to   take   Jamilah   out   of   the   house   for   fear  
she  would  be  humiliated  and  laughed  at.  
Jamilah   now   aRends   physical   therapy   twice   and  
month.   Thanks   to   support   from   UNICEF   Uganda   and  
the   Ministry   of   Gender,   Labour   and   Social  
Development,   Jamilah   now   has   a   wheel   chair   which  
Jamilah  in  her  wheelchair  provided  in  
enables  her  to  sit  upright  and  the  harness  keeps  her  
partnership  by  the  Ministry  of  Gender  Labour  
secure.  Her  wounds  have  healed  and  a>er  nutri6onal  
and  Social  Development
treatment   she   has   gained   weight.   She   enjoys   music  
and    responds  to  her  mothers  signing.  

HumaneAfrica’s approach
Once   children   have   been   located   and   therapy   and   assis6ve   devices   are   introduced,  
HumaneAfrica   works   with   the   family   or   caregiver   to   ensure   they   are   fully   suppor6ng   the  
child.  O>en  when  HumaneAfrica  first  visits  a  child  who  has  been  hidden  away  from  society,  
the   caregiver   does   not   show   affec6on  
towards   the   child.   They   do   not   speak  
directly  to  the  child  and  o>en  talk  about  
the   child   as   if   they   were   not   present.  
Once   the   therapy   and   support   begins  
however   there   is   o>en   a   no6ceable  
change   in   behaviour   towards   the   child.  
The   caregiver   sees,   perhaps   for   the   first  
6me,  someone  showing  love  and  care  to  
their   child.   Physical   therapy   is   especially  
affec6ve   as   the   therapist   may   massage  
the   child   while   speaking   directly   to   them,  
showing  respect  and  care.  HumaneAfrica  
has   seen   a   significant   difference   in   the   A  home-­‐based  physical  therapy  session  where  the  caregiver  
caregiver’s   response   to   the   child   before   is  also  trained  to  conduct  the  therapy
and   a>er   these   interac6ons   with  
therapists.   What   occurs   in   the   room   is   a  
subtle  change  in  the  social  norm.  Prior  to  the  therapists  interven6on,  it  was  acceptable  to  sit  
away  from  the  child  and  not  involve  the  child  in  discussions  or  give  them  aRen6on.  During  
the  therapy  session  however,  this  norm  is  challenged  by  an  individual  who  shows  care  and  
concern   and   communicates   directly   with   the   child.   Over   6me,   this   posi6ve   norm   of   caring  
and   showing   affec6on   is   adopted   by   all   those   in   the   room.   At   this   point   HumaneAfrica   looks  
towards  the  wider  community  with  a  view  to  changing  the  norm  which  makes  it  acceptable  
to  discriminate  and  abuse  children  with  special  needs.  
Social  norms  
The   theory   of   self   enforcing   social   conven6ons   has   provided   insight   into   why   harmful  
prac6ces  exist.  The  theory  uses  game  theore6c  models  to  explain  behaviour  in  the  presence  
of   social   conven6ons   and   social   norms.   It   highlights   that   when   a   social   norm   is   in   place,  
decision   making   is   an   interdependent   process   in   which   a   choice   made   by   one   family   is  
affected   by   and   affects   the   choices   made   by   other   families;   it   is   a   result   of   reciprocal  
expecta6ons  (UNICEF,  2010).  
The   decision   to   stop   a   harmful   prac6ce,   such   as   discrimina6ng   or   abusing   a   child   with  
disabili6es,   must   come   from   within   a   community   and   the   most   successful   approach   is   to  
empower  communi6es  to  decide  for  themselves  to  abandon  the  prac6ce.  Through  the  social  
norms   approach,   and   more   specifically   through   respeccul   educa6on,   dialogue   and  
workshops,   community   members   are   encouraged   to   re-­‐evaluate   their   current   beliefs   and  
aNtudes  in  order  to  bring  about  posi6ve  change.  

Methodology
Changing  social  norms  is  key  to  elimina6ng  the  s6gma  associated  with  disability  in  Uganda.  
Research   shows   that   throughout   Uganda,   this   s6gma   results   in   children   with   disabili6es  
being   excluded   from   society,  
o>en   being   locked   away  
without   access   to   proper  
nutri6on,   social   interac6on,  
educ6on   and   healthcare.   The  
abandonment   of   this   harmful  
prac6ce   is   achieved   through  
local   communi6es   ini6ally  
aRending   workshops   and  
establishing   an   open   and  
honest  environment  where  the  
issue  of  disability  can  be  openly  
discussed.  
HumaneAfrica’s   approach   is  
based   around   the   community   A  workshop  at  a  local  school  for  the  social  inclusion  of  children  with  
acknowledging   that   this   s6gma   disabiliCes
exists  and  has  an  adverse  effect  
on   children   with   special   needs  
in   their   community.   Through   workshops,   consis6ng   of   facilitated   group   discussions,   the  
community   establishes   that   every   child   with   or   without   disability   has   the   same   rights   to  
social  inclusion  within  the  community.  
Once  the  community  makes  the  link  between  their  aNtude  towards  a  child  with  a  disability  
and  a  child  who  has  been  abused  or  excluded  from  their  community,  the  community  has  the  
possibility  of  joining  together  to  collec6vely  abandon  this  harmful  prac6ce.  HumaneAfrica’s  
role  is  to  give  communi6es  the  opportunity  to  discover  this  link  for  themselves  and  support  
the  community  in  designing  and  implemen6ng  ac6vi6es  to  collec6vely  abandon  this  harmful  
prac6ce.  HumaneAfrica  has  a  presence  in  a  community  for  six  months  working  with  a  family,  
school   and   community   to   eliminate   the   harmful   prac6ce   of   discrimina6on   and   abuse   of  
children  with  disabili6es.  
Social inclusion of a child with special needs - case study
HumaneAfrica   was   asked   to   visit   Sanyu   in   November   2014   a>er   her   mother   had   seen  
HumaneAfrica’s   involvement   in   her   community   during  
a   project   to   eliminate   child   mu6la6on,   another  
harmful  prac6ce  affec6ng  children  in  Uganda.    Sanyu  
was   nine   years   old   at   the   6me   and   had   been  
diagnosed   with   cerebral   palsy.   Sanyu’s   father   le>   the  
home  when  Sanyu’s  condi6on  became  evident,  when  
she   was   about   three   years   old.   He   claimed   that   his  
side   of   the   family   do   not   have   children   with  
disabili6es   and   therefore   this   child   could   not   be   his.  
Sanyu’s  mother  had  no  income  or  property  and  went  
to  live  with  Sanyu’s  grandmother.  Sanyu’s  mother  is  a  
labourer,  she  digs  crops  for  landowners.    
On  mee6ng  Sanyu  for  the  first  6me,  it  was  clear  that  
Sanyu   was   a   happy   inquisi6ve   girl.   She   did   not   walk,  
but   crawled   around   the   floor   and   was   interested   in  
her   surroundings   and   had   good   eye   contact   and   an  
engaging   smile.   She   had   infected   soars   on   her   knees  
and  elbows  from  crawling  around  her  house.  She  was  
not   locked   in   the   house   during   the   day,   as   her  
Sanyu
grandmother  was  able  to  look  a>er  her,    however  she  
did  not  have  access  to  healthcare,  educ6on  or  social  
interac6on  with  the  community.  Sanyu’s  vocabulary  consisted  of  only  one  or  two  words,  she  
was  able  to  hold  a  pencil  and  was  interested  in  sketching.    
Sanyu’s   immediate   needs   were   to   treat   the   sores   on  
her  elbows  and  knees  and  find  a  way  for  her  to  move  
around   without   crawling.   HumaneAfrica   arranged   for  
physical   therapy   to   start   immediately   and   Sanyu   was  
measured   for   knee,   ankle   and   foot   supports   so   she  
could   start   learning   to   walk.   She   was   also   measured  
for  a  wheel  chair.    
A>er   a   few   visits,   it   became   clear   that   Sanyu’s   mother  
was   prepared   to   face   the   community   and   challenge  
the  s6gma  associated  with  having  a  child  with  special  
needs.   It   was   agreed   that   Sanyu   should   aRend   school.  
This   involved   registering   her,   buying   a   uniform   and  
acquiring  a  wheelchair  so  she  could  travel  to  and  from  
school.  
In  order  to  remove  the  s6gma  associated  with  Sanyu’s  
diagnosis,   HumaneAfrica   arranged   to   start   the   social  
inclusion   program   with   her   local   school.   The   ini6al  
workshop   was   designed   to   bring   the   students   and  
most   especially   the   teachers   to   acknowledge   that  
children   with   disabili6es   had   the   same   rights   and  
Sanyu  walking  with  her  knee,  ankle  and  foot   worth   as   children   without   disabili6es.   This   was  
supports achieved   by   running   a   workshop   in   the   school   which  
included   small   group   discussions   based   on   case  
scenarios   involving   children   with   disabili6es   and   the  
reac6ons   they   received   from   community  
members,   fellow   students   and   teachers.   The  
purpose  of  these  small  group  discussions  was  to  
illustrate   that   aNtudes   towards   children   with  
disabili6es   are   key   factors   as   to   whether   these  
children   became   part   of   the   community   or   are  
hidden   away.   Small   working   groups   were   then  
formed   with   students   and   teachers   to   design  
and   implement   messages   to   the   wider  
community.   These   messages   are   designed   to  
bring   the   en6re   community   to   collec6vely   and  
visually   abandon   the   prac6ce   of   discrimina6ng  
and  abusing  children  with  disabili6es.    

Sanyu  aEending  her  local  school

Summary
Support   services,   healthcare   and   educa6on   are   available   for   children   with   special   needs   and  
disabili6es  in  Uganda,  however  due  to  the  s6gma  associated  with  disability,  these  services  
are  generally  not  accessed  and  children  with  special  needs  rarely  experience  social  inclusion  
within  communi6es.  
The   harmful   prac6ce   of   discrimina6on   and  
abuse   towards   children   with   disabili6es   o>en  
results   in   parents   and   caregivers   hiding   their  
children   from   society.   However,   once   this  
nega6ve  social  norm  has  been  replaced  by  the  
expecta6on   that   children   with   disabili6es   will  
have   equal   access   to   community   resources,  
there  is  an  opportunity  for  children  with  special  
needs   and   disabili6es   to   fulfil   their   full  
poten6al.   Therefore,   the   social   inclusion   of   all  
children   with   special   needs   and   disabili6es   in  
Uganda   will   become   a   reality   only   when  
communi6es   openly   and   collec6vely   abandon  
the   harmful   prac6ce   of   discrimina6ng   and  
abusing  children  with  special  needs.  

2015  
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