Hesperian Health Guides
Chapter 54: Work: Possibilities and Training
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For most people, some kind of work is necessary in order to eat and have a place to live. In rural areas, the main work of many families involves farming, fishing, hunting and gathering, or other forms of food production. Equally important is the work of ‘keeping house’ and bringing up the family.
Who does most of the work within a family depends on local customs and the family’s situation. In most poor rural families nearly everyone—women, men, and children—help with the work of survival. By the time they are 5 or 6 years old, children may be helping to take care of the babies, feed the chickens, herd the goats, shell and clean the grain, and to carry out other tasks so that the older members of the family are free to do other work. In many societies, children by age 8 or 10 bring in more income (food or money) than it costs their families to take care of them.
Work that frees people and work that makes them slaves
Work—whether it is done by adults or children—can be either a good or bad experience. It can help persons gain dignity and independence. Or it can take away their dignity, freedom, and health. How workers are affected depends on work conditions, on the fairness of wages, on workers’ rights, and on how much respect and equality exists between workers and bosses.
In some situations, especially in cities, many children are forced to work long, hard hours in unsafe or unhealthy work conditions for very low pay. Such ‘child labor’ is cruel, and may result in permanent damage to the child’s body or spirit.
In some rural areas, children from the poorest families must also work long, hard hours under difficult conditions. But for many rural children, the opportunity to help their families with the labor of production and survival is a greater adventure than is ‘play’. The chance to take care of a real baby (not just a doll) or to help grow the family food, gives many farm children a feeling of importance, self-confidence, and personal worth that is not often seen in city children.
As a child grows up, to be wanted and well cared for is not enough. A young person needs to feel that he or she is needed. To become ‘independent’ can be important. But just as important is to develop an ability to do things for and with others, to contribute toward meeting the needs of family, friends, and community.
Too often disabled children are not given the opportunity to become helpful or needed, or to learn the skills to contribute in an important way to the family or community. The family and community need to look ahead to the disabled child’s future. They need to find ways to build on whatever strengths she has, so that she can have a full and meaningful role in the community.
A money-earning job is not the only meaningful role in society
In some cultures, especially in Europe and the United States, great importance is placed on work to earn money. Often it seems that a person’s worth is measured by how much money he or she makes. Where such a value system exists, a standard goal of rehabilitation is to prepare disabled persons to work at some kind of money-earning job.
But caution! This goal of a paid job may not be appropriate in some parts of the world. Traditions and local values differ from place to place. Some societies are more accepting of persons who do not earn or ‘produce’, as long as they contribute and take part in other ways.
Also, we must remember that in poor countries the unemployment rate (people without work) is often very high, even for the non-disabled. It may be very difficult for a disabled person to get a job, even if well-trained.
There are many ways, other than by working for money, that disabled persons can contribute to their family and community. They may be able to learn skills to help with daily activities in the home. Or they may become leaders for community action. As we discussed in Chapter 45, disabled villagers who are unable to do hard physical farm work, often make outstanding health workers (paid or volunteer), rehabilitation workers, popular organizers, or defenders of human rights.It is important that rehabilitation programs have a broad view of how disabled persons might work or fit into the community. Too often ‘skills training’ prepares a physically disabled person to do jobs that able-bodied persons could do just as well. The challenge, whenever possible, should be to build on the unique strengths, experience, and qualities of the disabled person: help her to find a role in society that she can do better than most non-disabled persons.
Rehabilitation programs and families should avoid planning a child’s (or adult’s) life work, or role in the community, for him. Rather, we should help make available as wide a range of opportunities as possible.
Our goal should always be to open doors for the child, not to close them.