PREFACE Four words that my Professor, Dr Suranjan Bhattacharji, spoke nearly 25 years ago have stayed with me. They were: “converting resource-burners into resource-earners”. Many people regard disability work just as a humanitarian task. This is far from the truth. Two sociological concepts that are inter-twined are poverty is expensive and disability handicaps the un-impaired. The fact that the disability of one person affects somebody who is not disabled is rarely appreciated. The phrase “no man is an island” is very apt in this situation. One person’s problem is indeed another person’s problem. If one person is not working, then another able bodied person has to work for himself/herself and the disabled person who is not working... and also for the care-giver who is also not working. It is therefore in everyone’s interest that the disabled and their caregivers earn for their upkeep as far as possible. Interestingly, the reasons for the disabled not working are not always medical. If you look out of your window onto the road outside, there is a high chance that you will see an un-sung innovation of astounding magnitude. This is the ubiquitous 2-wheeler with 2 additional wheels attached, being ridden by people with locomotor disabilities. These are people whose earlier lives and souls had been incarcerated within their houses with devastating sociological consequences to their families. Countless numbers of such persons across the country have been magically liberated and transformed. They now work, live meaningful lives and love what they can do to contribute to society. And it all started because of ignited minds and 2 wheels. The St John’s Handbook of Rehabilitation seeks to ignite more minds. India’s economy is booming. It is reckoned as one of the super-powers in the decades to come. However within this success story there is an un-appreciated sump into which the national economy is draining. The World Health Organisation states that approximately 10% of the population of any country is disabled. India’s population has crossed 1.2 billion; this means there are about 12 crore disabled people in India. Our belief is that the social dimensions of disability go far beyond the disabled person, the family and the community and affects the whole nation. The 12 crore disabled people in India can be triaged into people with mild, moderate and severe disability. Triage is done with the aim of maximizing results, and historically focuses primarily on the moderately affected group. Most of these moderately disabled people are mostly not working, and consequently not contributing to the nation’s economy. However the problem is bigger than 3 or 4 crore people, as many, in addition, need a family member to look after their various needs. xvi The St. John’s Handbook of Rehabilitation Thus there are about 6 crore people in India who are not contributing to the national economy. Yet, many of them - with our concerted effort - could be relatively easily transformed from resource-burners into resources-earners. (In India, the numbers are so large that even a small margin can result in huge dividend.) The St. John’s Handbook of Rehabilitation is an impetus to drive a juggernaut across India in order to reach these millions of people with the aim of restoring human dignity and creating resource-earners. This juggernaut includes people, hospitals, tertiary centres, governments, corporates, voluntary organisations and funding agencies. Many of these groups have already come together. An on-going on-line training to train the primary physicians, to impart knowledge, bring about an attitudinal change towards disability, and to give them practical information is envisaged. Work on this front has also begun. Work to open up economic opportunities for the large numbers of newly empowered people with disabilities willing and wanting to contribute to the national economy has also started. Rehabilitation, I believe, is not the exclusive purview of rehabilitation specialists, and so the door was opened to all people from specialities to contribute to this Rehabilitation handbook. The outpouring of goodwill and the number of articles that we received swamped us. We received a deluge of articles from patients, caregivers and professionals from many disciplines, many countries, and several national and international organizations. By the time we sorted out the articles, we were thrilled to note that amongst the mails received were articles from an organisation that had won the Nobel Peace Prize and two Fulbright scholars. (Interestingly 53 Fulbright scholars to date have won the Nobel Prize.) Within these hundreds of people who have invested in the Handbook, now lies vested the countervailing power of this Handbook. [John Kenneth Galbraith]. Compiling The St. John’s Handbook of Rehabilitation is only the first step in rehabilitating the many, many disabled people in India, and turning them into an economic force. This is a task for which we need your help. Dr Kurian Zachariah Editor, St John’s Handbook of Rehabilitation 4th November, 2014 Bangalore.