Learned helplessness to Helper, Empathic Distress to Compassion: Scope and
Challenges for Inclusive Education in Bhutan
Keynote Address
First, I would like to express my gratitude and thanks to the organizers for giving
me the opportunity to be the first speaker in this section of the Regional Seminar
on Inclusive Education for Children with Disabilities. I believe the subject of
this seminar is very relevant in the context of the overall development of education
in Bhutan and the global theme for observation of the International Day for
Persons with Disabilities, which is, “Break barriers, open doors: for an
inclusive society for all.”
Bhutan has come a long way in educational development. From having virtually
nothing in the 1960s, we can now boast of several hundred schools and many
colleges which provide probably the best education in our part of the world. I have
full admiration for all the teachers and educationists in the Ministry of Education
and Royal University of Bhutan. In my opinion, you are always one step ahead of
other Ministries and agencies in the country – which you should be, given that
education is the foundation of development. So it is no surprise that you are now
embarking on this challenging task of including children with disabilities in the
mainstream schools in our country. Thus, it is most appropriate that this important
Regional Seminar on Inclusive Education for Children is conducted in the
esteemed Paro College of Education, the citadel of education of our future
generation of teachers. I would like to congratulate the organizers for their
wonderful preparation and welcome all the experts from abroad. I am sure our
Bhutanese participants will learn a lot from this seminar.
Let me explain how and why I got involved in disabilities so as to justify why I am
standing here today. At the outset, I must admit that I am no expert on disabilities.
Most of you attending this seminar may know more about disabilities than I do.
However, I can say with confidence that I have lived all my life with people with
disabilities, be it in my own family, at work, or in the community. I have come
across people with the severest of disabilities who have very difficult lives, as well
as people who are very successful even when they have multiple disabilities. We
have among us today many successful people living with disabilities. I would like
1 to particularly mention a few names, including Sanga Dorji, first Bhutanese
physiotherapist; Pema Chophel, Sr. Program Officer, Special Education Division,
MOE and Kinga Dorji, Program Officer, CAPS Division, MOE. Each of them and
others like them are leaders in their own fields. They are the role models and
sources of inspiration for all people, not just with disabilities. I extend my full
admiration to them.
Like many people all over the world, including in Bhutan, I must admit that when I
was younger I had prejudices and misgivings about people living with disabilities.
Societies that are ignorant of the potential of people with disabilities seem to have
more negative stereotypes in this regard. So when I was young, I wondered, if they
were not able to look after their own needs, would they be able to contribute
anything to society? The turning point of my belief came when I attended a
SAARC Ministerial Conference on Disabled Persons in Islamabad in December
1993. I came across many professionals and bureaucrats working in the field of
disability, as well as people with disabilities showcasing their skills and talents.
That was an eye opener. My confidence in people with disabilities was further
reinforced during a visit to Australia in 1998. There, I saw people with paralysed
legs moving around independently in wheelchairs. They could access virtually
anything – public buses, bathrooms, shopping malls, hospitals, schools, offices or
their home in a multi-storey building. Nothing seemed to stop them.
Likewise, when I went to Japan in 2002, I saw people with impaired vision
walking independently with their white canes in the city streets, train and bus
stations, and airports. There are engraved routes on all pavements in Japan for
visually impaired persons, which facilitate their sense of direction. Therefore, it is
not only the person with the disability who determines their ability to function
independently; a lot depends upon the availability of facilities for them. In a
mountainous and difficult geographical terrain like Bhutan, even people like me,
who have no permanent physical problems can encounter challenges: Last October,
I went on a pilgrimage to Singye Dzong in Lhuentsi. Although, I managed to
eventually reach this remote destination after three days of trekking, I couldn’t
catch up with my group. What took 6 hours’ walk for them took me 10 hours. So,
should I call myself disabled? Or should we say that each individual has different
abilities?
2 By way of example, I would like to share some anecdotes of my other trekking
experiences with my friend Sanga, who is blind. Together, we have trekked many
places in Bhutan, including Dagala, Chomolhari, Dongkala and Lungchotse. What
amazes me is the dexterity of his ankles to negotiate the most rugged footpaths,
filled with uneven boulders and muddy slush. He has never complained of pain,
nor has he had a sprain or foot injury. This made me realize that disability in one
function of your sense organs need not disable you in other functions of the body.
To put it simply, Sanga has shown me that being blind does not necessarily make
you disabled. As I mentioned earlier, he also has excelled in his profession. He has
a loving family, a beautiful young wife, an intelligent, pretty daughter and a busy
social life. Some of his professional clients include members of the Royal Family
of Bhutan.
Sharing many wonderful moments with Sanga on top of the mountains inspired us
to do something for the people living with disabilities in Bhutan. That’s how we
conceived the idea of forming an NGO for this purpose. In 2010, together with a
group of visually impaired persons, most of whom are here today, the Disabled
Persons Association of Bhutan (DPAB) was registered with the Civil Society
Organization Authority of Bhutan as the first public benefit NGO for people living
with disabilities. The main objective of the DPAB is to create awareness on
disabilities, advocate for the rights of all people living with disabilities, and
improve the education, vocational skills and living conditions of people with
disabilities in Bhutan. We also now have two more NGOs for people with
disabilities – Ability Bhutan Society and Drak-Tsho Vocational Centre for
Disabled Persons.
Even before it was officially recognized, DPAB, along with Drak-Tsho and other
agencies, initiated observation of the first International Day for Persons with
Disabilities in Bhutan on 3 December 2008. We were very fortunate that His
Majesty the King gave an audience to some 100 persons with disabilities, in the
Royal Palace in Thimphu. HM presented a huge cake and souvenirs of his
Coronation that year to the participants. The participants also had the opportunity
to offer khadhars and good wishes to the King. Later that day, the participants put
on a spectacular cultural show as part of the Centenary Celebrations of our
Monarchy. In subsequent years, members of the Parliament and the business
3 community were among the participants, and the occasion now is observed
annually through the Special Education Division of the Ministry of Education.
Distinguished participants, ladies and gentlemen,
The concept and definition of disabilities depend upon how you look at them and
from what perspective. They have evolved over time, from a simplistic notion that
any person with an “impairment” of mind or body is disabled to a more complex
one that considers the relationship between an individual and their environment.
But no matter how you view it, the fundamental requirement is the right of people
with disabilities to access resources within their society on an equal basis with
others.
In that context, the Government of Bhutan has shown its political will with the
ratification of the Convention on the Rights of the Child. In Article 23, the CRC
declares: “Parties recognize that a mentally or physically disabled child should
enjoy a full and decent life, in conditions which ensure dignity, promote selfreliance and facilitate the child’s active participation in the community.”
Bhutan also is committed to achieving the Millennium Development Goal of
Universal Primary Education, which requires an explicit focus on access to
inclusive education and specialist support for children with a disability.
Critically, Bhutan has signed the Convention on the Rights of Disabled Persons in
2009, although this is yet to be ratified by the Parliament. The 11th Five Year Plan
and the new Government’s campaign manifesto both commit to services, including
education, for people living with disabilities. While the intentions are clear, it is
important that we now translate them into action.
His Majesty’s Welfare Secretariat has supported persons with disabilities in many
ways, such as through granting land for landless disadvantaged families with
disabled members; offering stipends to unemployed persons with disabilities; and
financial support for the education of children with disabilities from poor families.
At the same time, the Ministry of Education has set up a special division to look
after the educational needs of children with disabilities. A national policy on
special education has been drafted and awaits final approval. At the societal level,
there also now exists a higher degree of compassion and acceptance of persons
4 with disabilities. Already eight schools in the country receive children with
disabilities. Moreover, the first batch of hearing-impaired children from the
integrated school in Paro is set to graduate in the next couple of years. We have
come a long way from the lone school for the blind started in the early 1970s in
Khaling.
On the prevention front, Bhutan has achieved remarkable progress too. Iodine
deficiency goiters and severe mental disability have virtually disappeared due to
the iodization of salt; polio and other life-threatening diseases are well-controlled
by immunization of very high numbers of children; blindness and other nutritionrelated disabilities are curbed through improved nutrition; and nerve damage and
loss of limbs have been reduced through appropriate treatment of diseases like
leprosy.
Even so, we are still not fulfilling the needs of every child with disabilities. In
particular, untreated mental disorders and drug and alcohol addiction are taking a
heavy toll, resulting in the loss of young lives and livelihoods among many people.
As our treatment services improve further, many children with congenital
disorders, who otherwise would have died, will now live with severe disabilities.
But we must ensure that in increasingly urban settings, many persons with
disabilities, who otherwise could be gainfully employed in traditional societies in
rural areas, do not become marginalized.
Distinguished participants, ladies and gentlemen,
Accessibility does not and should not mean only physical accessibility for persons
with disabilities, although this continues to be a major problem in our country due
to the lack of facilities and the difficult terrain. Instead, accessibility encompasses
a whole gamut of opportunities and incentives that persons with disabilities can
obtain in order to enhance their knowledge and skills to enable them to participate
fully in society, become independent, and lead meaningful and satisfying lives.
Therefore, the recent call by the local DPOs to the Government for Universal
Access in Design represents a fundamental step in this direction. Even the recent
introduction by our new Government of dedicated seats for the elderly and people
with disabilities on public transport are welcome signs of recognition of the needs
of people with disabilities. Further initiatives such as these, which are doable
5 without the need for much resources or expertise, must be implemented without
delay.
It is estimated that Bhutan has as many or more persons with disabilities when
compared to other developing countries. Worldwide, disability accounts for 15%
of the population. Yet the most recent study, conducted jointly by the Ministries of
Education and Health, the National Statistical Bureau and UNICEF in 2010, has
shown that up to 23% of our children aged 2-9 years have some form of disability,
mainly cognitive intellectual disability. Among them, around 3% have a severe
disability. Earlier, the Housing and Population Census 2005 also showed that more
than 5% of our population has severe disability. The issue is exacerbated not only
by the fact that more than half of our population is younger than 25, but also by the
dearth of professionals, institutions and facilities that I mentioned earlier, and by a
persistent lack of awareness by many people.
As much as individual persons with disabilities have the responsibility to
participate and engage themselves to improve their living and vocational skills,
Government and society as a whole have the obligation to provide the necessary
facilities to maximize the capabilities of persons with disabilities to contribute
meaningfully to their own, and society’s well-being. Moreover, implementation of
programmes for the prevention of disabilities is as important, if not more
important, and more cost-effective than providing treatment or rehabilitation. Our
development philosophy and goal of a State of Gross National Happiness cannot
be fulfilled if the needs of the disabled persons in Bhutan are not addressed
adequately.
Let me now briefly touch on the subject of inclusive education for children with
disabilities. Research has shown that children with a disability – especially an
intellectual or sensory disability – are less likely to attend school. Disorders like
autism and ADHD pose special challenges and require specially trained teachers
and resources. In resource-poor communities, especially in remote settings,
children with a disability who are not included in their local school tend not to
attend school at all. Exclusion from school greatly impacts further opportunities as
an adult. It is well-known that poverty, disability, lack of education and lack of
health care are all closely connected.
6 Where education opportunities are made accessible, people with a disability have
greater opportunities for further learning and employment and, in turn, are more
likely to engage in social and economic opportunities. Inclusive education acts as a
broad strategy to address marginalization and promotes the rights of all children to
participate in mainstream education. Inclusive education approaches also allow for
the experiences of people with a disability to be embedded into the broader social
context. Children with a disability should have the right to access the most relevant
education option. This could be inclusive education at their local school,
mainstream education with specialist support, a specialist unit connected to a
mainstream school, partial integration, or learning in a specialized setting. When
specialist school settings are harnessed as a support to inclusive education, such as
in inclusive education resource facilities, limited resources go further since they
frequently service a cluster of schools, not just one setting.
Now let us look at the financial cost of inclusive education. The economics of
disability have three distinct elements: 1) direct cost of treatment and
rehabilitation, including associated travel and service fees; 2) income foregone by
the person with a disability, who is unable to access employment; and 3) income
and other costs lost by those supporting or caring for people with a disability, such
as time available for paid work or going to school.
Overall, research shows that disability affects the economic wellbeing of 20 to
25% of households in Asia. Even so, the costs associated with including people
with a disability in development programmes are far outweighed by the long-term
financial benefits to individuals, families and society. Further, these costs are often
minimal when disability-inclusive practices are present from the planning and
design phase. For example, it has been estimated that using universal design
principles to make a community centre and a school accessible added less than 1%
to the overall costs.
Needless
inclusive
Teachers
teaching
teaching
inclusive
to say, every teacher needs pre-service and in-service training on
education, as well as a support system that offers specialist help.
also need to be supported by sound policies, timely supervision and
resources. People with disabilities themselves could be involved in
and the development of teacher training curricula to strengthen the
education process. Lastly, teachers should be given the option to work
7 with disabled children in and out of school settings. Alternative avenues like nonformal education for children with severe disabilities also could be explored, while
access to basic assistive devices is an essential component for successful disabilityinclusive education.
Distinguished participants, ladies and gentlemen,
Finally, as a health worker and psychiatrist, I would like to share with you some of
the risks that people working with disabilities may face over time and how they
can overcome them. Professional burnout is a particularly high risk for people
working with disabilities, and is manifested in many ways. It may result in passiveaggressive behaviour, where a person learns to show his aggression by not
cooperating or taking the initiative. It may manifest in “learned helplessness,”
where those who are repeatedly deprived of opportunities will not take such
opportunities when they do come. It may show up in displacement, a psychological
defence mechanism whereby an individual “moves” his anger or frustration from
one person to another, usually to a weaker one; for example, a teacher who is angry
with the head teacher may displace her anger to her student instead. Or it may
result in empathic distress, which describes the inability to tolerate the perceived
pain or suffering of another, and which ultimately leads to withdrawal or inactivity.
What can be done if our teachers show such symptoms? Of course, many things
can be done, from managerial and administrative reforms to individual
inducements and rewards. But I would like to share with you something that is
completely doable, that is inherently available within us and that is a fundamental
requirement in the helping profession: Compassion.
The definition of compassion is often confused with that of empathy and altruism.
Empathy is the emotional experience of another person’s feelings; it is, in a sense,
an automatic mirroring of another’s emotion, like tearing up at a friend’s sadness.
Altruism is an action that benefits someone else. It may or may not be
accompanied by empathy or compassion, for example, in the case of making a
donation for tax purposes. Although these terms are related to compassion, they are
not identical. Compassion often does, of course, involve an empathic response and
an altruistic behaviour. However, compassion is defined as an emotional response
when perceiving suffering, and involves an authentic desire to help.
8 And this is what matters most to us as teachers. If we have a genuine compassion
to help others, not only will it benefit the students that we teach, but scientific
research has shown that it will also help us to remain healthy, happy and satisfied
with our work.
Just as we all have Buddha-nature in the core of our hearts and minds, both
animals and humans have a compassionate instinct. Compassion is a natural and
automatic response that has ensured our survival. Darwin is less known for his
“survival of the kindest,” but in The Descent of Man he comments that
“communities which included the greatest number of the most sympathetic
members would flourish best, and rear the greatest number of offspring.” Kindness
is thus one of the most highly desirable traits when selecting partners. Compassion
may have ensured our survival because of its tremendous benefits for both physical
and mental health and overall well-being.
Some research even has shown that compassion may lengthen our life-spans. For
example, brain-imaging studies showed that so-called “pleasure centers” in the
brain are equally active when we observe someone giving money to charity as
when we receive money ourselves. Another experiment showed that giving to
others even increases well-being above and beyond what we experience when we
spend money on ourselves. Social connection strengthens our immune system and
helps us recover from disease faster, while also raising self-esteem and lowering
rates of anxiety, depression and stress. Those who are happy because they live a
life of purpose or meaning – in other words, focused less on self and more on
others – have been found to have lower levels of cellular inflammation, which is at
the root of cancer and other diseases, than those who say they are happy but live a
more hedonistic lifestyle. Because those with compassion are more trusting and
cooperative, others are more open to trusting and cooperating with them. Social
connectedness therefore generates a positive feedback loop socially, emotionally
and physically.
Finally, compassion has the ability to change the world. Why are the lives of
people like Mother Teresa, Dr. Martin Luther King, Jr., and Desmond Tutu so
inspiring? Research suggests that seeing someone helping another person creates a
state of “elevation.” That elevation then inspires us to help others and start a chain
9 reaction of giving. Indeed, compassion is contagious: As in the positive feedback
loop I just noted, social scientists have demonstrated that acts of generosity and
kindness beget more generosity in a chain reaction of goodness. Our acts of
compassion uplift others and make them happy and if the people around us are
happy, we, in turn, become happier.
So now the obvious question is, how can we cultivate compassion? Although
compassion appears to be a natural instinct, it sometimes helps to receive training.
A number of studies have now shown that a variety of “loving-kindness”
meditation methods, mostly derived out of traditional Buddhist practices, may help
cultivate compassion. But cultivating compassion does not require years of study
and can be elicited quickly, especially in our Buddhist culture. Eight- or nine-week
meditation trainings have been scientifically found to help participants to act more
compassionately toward a person who is suffering.
In a particularly notable example, the Centre for Compassion and Altruism
Research and Education at Stanford University, led by James Doty and Khenpo
Jimba, has developed a secular compassion training known as the Compassion
Cultivation Training Programme. Preliminary research suggests that this is proving
helpful in reducing ailments such as social anxiety and that it elevates different
compassion measures. The Mind and Life Institute, led by His Holiness the Dalai
Lama, has also made significant progress in brain mapping and studies on
compassion and meditation. In addition, the Max Planck Institute, led by Dr. Tania
Singer, has launched a major project to study effects of compassion meditation on
the brain and body.
Distinguished participants, ladies and gentlemen,
As citizens of a Vajrayana Buddhist country whose ideals are to alleviate the
sufferings of all sentient beings, it is natural for us to feel compassion for others in
general, but even more so for people with disabilities. Yet the strains of modern
life and an accelerating consumerist attitude often overwhelm us. So this new body
of scientific knowledge on compassion should bring us “back home” to accept and
practice our spiritual heritage and traditions.
10 This Regional Seminar provides us an opportunity to learn more on the subject of
inclusive education from visiting experts from abroad as well as within the
country. This also is a valuable platform to showcase the achievement of persons
with disabilities and their contribution to society as a whole, as well as to create
awareness and advocate for their rights and their special needs. Finally, this is an
occasion to take stock of what we have done, as a country, society or individuals,
for persons with disabilities so far – and what still remains to be done. Each and
every one of us has a responsibility in this regard. Let us begin by learning more on
inclusive education. Thank you, and Tashi Delek.
Dr. Chencho Dorji
Psychiatrist
Jigme Dorji Wangchuk National Referral Hospital
Thimphu: Bhutan
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