Financial aid for the rehabilitation of individuals with spinal cord injuries in Bangladesh

Abstract

In Bangladesh, a majority of individuals with spinal cord injuries (SCI) are either poor or very poor. In most cases, their families undergo extreme hardship as they lose the income of the only or main earning member, and are unable to bear costs of rehabilitation. Purpose: This mixed method study explored perspectives of individuals with SCI regarding financial aid in the form of interest-free loans for their treatment and rehabilitation at the Centre for the Rehabilitation of the Paralysed (CRP). Method: In the first part of the study, 10 semi-structured face-to-face interviews were conducted. In the second part of the study, 40 persons with SCI were surveyed. The qualitative method involved selection of respondents according to their age, sex and severity of disability. Quantitative interviews were conducted with all persons with SCI in the final stage of hospital rehabilitation, in the third quarter of 2008. Results: Though CRP provides financial support depending on the individual's economic status, many persons with SCI needed additional funding from multiple sources, such as savings (42.5%), mortgaging assets (12.5%), selling assets (45%), receiving loans (37.5%), begging for money (42.5%), and receiving donations from relatives (47.5%) or the community (30%), to meet the direct and indirect costs of rehabilitation. Majority (85%) of those interviewed wanted to receive financial aid in the form of interest-free loans. 76.4% of them wanted the loans to be disbursed in two phases; initially, to offset some of their costs during rehabilitation at CRP, and thereafter, for economic reintegration in their community. The remaining 23.6% wanted the loan only for vocational reintegration. 70.59% of those interviewed proposed repayment in monthly instalments, while 17.64% suggested quarterly instalments and 11.76% favoured annual instalments. Over half of the participants (55.88%) wanted to have vocational training, and the rest wanted vocational training for their family members, to enable them to repay the loan. Conclusions: This study revealed that there is a huge demand for interestfree loans among people with SCI. An appropriately designed interest-free loan programme, which would be sensitive to individual needs, could save people with SCI and their families from bankruptcy. This would also make SCI rehabilitation programmes more sustainable, and possibly reduce over-dependence on the donors. Further action research is recommended to evaluate the effectiveness of such a course of action.