Disability, as measured by whatever
yardstick
Seventeen years after an Act was introduced to
provide equal opportunities to the disabled, inconsistency continues to plague
the process of evaluating just how much a person is disabled. Disability is
today expressed in percentage terms but a uniform system of certification
eludes the country.
A candidate whose locomotive disability was
certified at 40 per cent by the Darbhanga Medical College, authorised for this
purpose by the Bihar government, ranked 113 in IIT-JEE this year under the
general physically handicapped category. Yet, during counselling, he was found
unfit for admission because a medical board comprising AIIMS doctors ruled his
disability was only 23 per cent.
In 2003, an MBBS student diagnosed with a
locomotive disability was denied admission by Delhi University to a
postgraduate course, his certificate from the state government's Lok Nayak
Hospital notwithstanding. And in 2007, a partially blind student of Delhi
University was denied a writer to assist her in exams, though a state
government certificate had put her vision loss at 50 per cent.
At the centre of such disputes are candidates
who, eyeing the 3 per cent reservation under the Disability Act, invariably
have certificates from state medical colleges but then find these rejected by
boards appointed by central institutes.
This year, Delhi University abolished its
medical board and declared that a certificate from any government medical
college would do. Dr Bipin Tiwary, dean of students' welfare in DU's wing for
the physically handicapped, says, "A question we raised was that being a
government university, how can we doubt the integrity of certificates issued by
our own government hospitals? This double examination causes undue harassment
for students."
But the IITs and the IIMs, the UPSC, AIPMT,
AIIMS, JIPMER, and JNU all insist on a double check. "If we can sit for
the entrance on the basis of our existing certificate, why do we need to go
through an examination by a separate board after we qualify in the same
entrance?" says Amit Kumar, the IIT aspirant who lost out this year. IIT
authorities say their rules are advertised beforehand. "If the candidate
had a problem with the rules, he should not have applied, or should have
protested earlier," says Dr G B Reddy, IIT-JEE chairperson.
Right to certify
In 2002, the
Delhi High Court observed that though the Persons with Disabilities Act, 1995,
stipulates that a medical board specified by notifications will be authorised
to issue disability certificates, no such notifications had been passed till
then. This was after a petition by an NGO. "For the last more than six
years, it did not occur to the authorities that the basic requirement is to
specify such medical authorities by means of a notification," the court
observed.
The court identified
nine government hospitals in Delhi; this was followed by a Central directive
that government hospitals across the country would be authorised to issue such
certificates. But a survey in 2010 found barely 35 per cent of the disabled had
managed a certificate.
In December
2009, the Act was amended and fresh guidelines issued, aimed at decentralising
the procedure. On paper, the issuing authority was changed from a medical
"board" to an "authority". A list of central government
hospitals was notified to issue certifications for three kinds of disabilities
— locomotive, visual and hearing. A tiered system was created under which
"obvious" disabilities could be certified by even primary and
community health centres; "non-obvious" disabilities examined by a
single specialist; multiple disabilities checked by a board set up for that.
Three years on, no hospital among AIIMS, Safdarjung, PGI Chandigarh and JIPMER
has made a single-specialist decision. Doctors say a board helps reach
"consensus" in a dispute.
The
amendment also saw the first official guidelines being released for expressing
disability in percentages. It set a deadline for issuing a certificate —
between a week and a month of request — but at AIIMS, say, the waiting list
runs into months. Besides, the objective of decentralisation is defeated by the
fact that no state other than Gujarat, Bihar, Goa and Tamil Nadu has notified
the new rules.
Discrepancies
Says Dr
Anoop Raj, head of the ENT department at Maulana Azad Medical College
associated with Lok Nayak Hospital, "Now we have formed a general rule in
our department. We don't let our doctors consult past certificates of
candidates, because we found they were getting influenced."
In ENT,
doctors say they do audiometry tests if loss of hearing is obvious, a speech
test if there is any room for doubt, and a brain response system for
evaluation. "A district hospital will have an audiometry test but not the
more advanced tests. These are the problems that create differences," Dr
Raj says.
Dr Nonica
Laisram, head of physical medicine and rehabilitation at Safdarjung Hospital,
insists the 2009 guidelines are specific. "When other states follow their
own rules, it creates disputes. We do not have this problem within our
department, but we usually give certificates only to patients who have been
treated in our OPD, except in medico-legal cases."
And, says
JNU's dean of students' welfare Prof Abdul Nassey, "Different states still
follow different rules, even though all certifications are from government
hospitals. The medical officer in our health centre evaluates these candidates
again, to factor in these variations and take the final decision."
The tests
are standard in visual disability, for instance. However, says AIIMS's
opthalmology head Dr R V Azad, "It depends on how the doctor factors in
small margins, say the difference between 6/16 and 6/18. If small centres do
not have the facilities for all tests, they may be doing their own thing... We
have so many rules. We have the WHO rules for certifying blindness, we have our
own rules under the National Blindness Control Programme, and we have a
completely different set of guidelines from the Ministry of Social Justice and
Empowerment for certifying disability."
Dispute
Reena
Bhatia, who was denied a writer by DU in 2007, says, "On the one hand we
are told that even primary health centres are authorised. But I had a
certificate from a state medical college, and even that did not satisfy the
university."
Doctors from
states accuse the Centre of a "hedonistic attitude". "When our
institute, which has government authorisation, says the student is disabled,
what right has the IIT to subject him to a second examination, and actually
counter our claims?" says Dr Suraj Nayak, medical superintendent at
Darbhanga Medical College. "We follow all standard guidelines." AIIMS
doctors who examined Amit Kumar felt his condition could have improved through
surgery.
A Delhi High
Court judgment in 2003 had certified that the decision of a government medical
college would be binding and always override boards set up by institutions.
"On a conjoint reading of Section 58 of the Disabilities Act and Rule 4 of
the Disability Rules, it will be crystal clear that individual universities,
institutions or establishments have no alternative but to accept a certificate
issued by the medical boards constituted by the governments," the court
had observed.
University
authorities say they double check for fear that the disability clause has been
misused. Yet, as Dr Tiwary of DU points out, "Such misuse is possible in
all reservations. We have so many cases of fake caste certificates being
generated... Viewing the disabled with this suspicion is not justified."
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