1. SPECIAL EDUCATION AND REHABILITATION PROFILE
Disability in Costa Rica:
According to Peace Corps Project Summary Sheets, there are an estimated 240,000 disabled persons in Costa Rica. The incidence of disabling conditions and diseases is not well documented in Costa Rica. However, based on statistics in comparable developing countries, experts estimate that 1214% of the total population is handicapped. Major handicapping conditions are distributed nationwide approximately as follows:
In 1954, a major polio epidemic left more than 1,000 persons with severe disabilities.
Costa Rica has the highest level of sound pollution in Latin America. A random sampling indicated that 6% of Costa Rica's population has a hearing impairment or loss. The situation is more problematic in rural areas since children are not routinely screened for detection of problems and those who have problems do not receive adequate medical attention.
Causes of blindness and deafness in Costa Rica are thought to be basically preventable. Such causes include infection and malnutrition, which predominate in rural areas.
Costa Rica has one of the most extensive and progressive networks of services to disabled persons of any country in the Americas.
Several sectors of the Costa Rican government have active programs addressing the needs of disabled children and adults. The Ministry of Public Health supervises a network of maternal and child care centers. The Ministry of Education provides extensive public special education, and the Ministry of Labor and Social Welfare provides vocational development services and special social security payments for some disabled persons.
The Department of Special Education in the Ministry of Education offers a creative range of special education services throughout Costa Rica. In addition to the special education schools, the Department has developed projects integrating handicapped students into regular classrooms. While needs are still substantial, the staff of the Department of Special Education provides an impressive public special education system.
The Ministry of Health and the National Insurance Institute provide diagnostic equipment for treatment in rehabilitation facilities. Programs treating muscular and skeletal disorders are fairly well developed.
The National Council on Rehabilitation and Special Education directs national policy and planning efforts in coordination with the various government ministries and private organizations.
The University of Costa Rica now has a teacher training program in special education, graduating its first class of special educators in 1976. A number of new areas of training such as comprehensive rehabilitation are in the planning stages. Portland State University and the The University of Oregon have provided assistance in the development of these programs through the Partners of the Americas.
There are at least 25 special schools in Costa Rica, most located in the highlands. The largest special school, the School of Special Education of Guadelupe (San Jose), provides services for 400 blind, deaf and mentally retarded persons. The school has diagnostic services, and vocational training in carpentry, upholstery, cooking, sewing, tailoring, weaving and mattress-making.
A recent effort has been made to integrate handicapped children into the regular school system in Costa Rica. Special education schools, and special education classes attached to regular schools, have existed only since 1973. Services for the more severely handicapped children depend primarily upon government financing and are still very limited.
The San Juan de Dios Hospital provides rehabilitative services for muscular and skeletal problems including polio complications, paralysis, and burns. The Hospital has a clinic for amputees headed by a team of orthopedists, social workers, physiotherapists and prothesis technicians who evaluate and treat patients. Opthalmological, otolaryngological and neurological services are also available. A shortage of psychologists and psychiatrists reduces administration of I.Q. and personality evaluation tools at the Hospital.
The National Rehabilitation Center, which opened in June of 1976, is one of the most modern in all of Central America, combining some of the best features of rehabilitation hospitals in the United States and Mexico. It has facilities to attend to 300 patients per day with an 80-bed capacity for confined patients. In addition to consultation and treatment, other services include diagnosis, therapies, and the manufacture of orthopedic equipment. There are gymnasium facilities with a hubbard tank, swimming pool, diathermy and electrotherapy, as well as immersion tanks, parafin applications and hydrotherapy. There are plans to centralize all physical, medical, physiotherapy and rehabilitation services in the country through the Center.
Legislation Affecting Disabled Persons:
The National Commission for Rehabilitation and Special Education was created in 1971 through Decree #1968 SPSS. The Commission was replaced in 1973 by the Council for National Rehabilitation and Special Education, which is responsible for planning and policy development in special education, as well as coordinating related efforts of the Ministry of Public Health, the Ministry of Labor, the Social Security System, the Ministry of Education and other public and private institutions.
By law, special education classes may not have a ratio of more than 12 students per teacher. Most special education schools have 40-120 students, one-half of whom are mentally retarded and the other half hearing or speech impaired.
II. PEACE CORPS ROLE IN SPECIAL EDUCATION AND REHABILITATION
The Peace Corps has been working in special education projects in Costa Rica since 1973. Ten volunteers served in the project between 1973-1977. The first, a special assignment volunteer, was assigned to work with deaf students. The Ministry of Public Education has been Peace Corps' host agency for special education and supports the program enthusiastically.
Costa Rica's Special Education and Rehabilitation Program is organized into three main project areas: Physical Therapy and Other Health Specialties (Rehabilitation I), Special Education and Audio-Visual Handicap Prevention.
Peace Corps' rehabilitation project results from a need for human resources at the new National Rehabilitation Center (opened in June, 1976). Peace Corps Volunteers in this project work, in large part, through the National Rehabilitation Center where they are involved in training personnel and providing medical care to patients. Among their goals are the:
• development of a system to determine the incidence of disability and debilitating diseases;
• survey of disabled persons to determine the nature of disabling conditions;
• inventory of resources available to assist disabled persons;
• development of a preventive program and early detection system;
• opening of diagnostic centers;
• encouragement of a team approach and philosophy for an integrated rehabilitation program which considers physical, social, educational, psychological and vocational factors in the overall rehabilitation of the patient; and,
• promotion of employment for disabled persons.
Other volunteer assignments in Rehabilitation I include working at the National Rehabilitation Center's hospital as physical therapists, dieticians, prosthesis design technicians, occupational therapists, rehabilitation nurses and physicians.
There were 14 volunteers serving in the special education project in 1979. Most were assigned to work as Special Education Resource Teachers.
Volunteers in this project work in many areas of disability including mental retardation, learning problems, emotional problems and infant stimulation. Working directly with the Department of Special Education, they provide teacher and family training in therapeutic techniques and act as resource persons and consultants in their various assignments. The first volunteers to work in this capacity were three volunteers who had transferred from Peace Corps' physical education project. As a result of their work, the first Special Olympics was held in Costa Rica in 1978.
The following represents some of the accomplishments of volunteers in the special education project:
• assisted in developing Costa Rica's International Special Olympics Games;
• trained over 120 teachers for the mentally retarded, over 80 teachers for learning disabled students, over 30 teachers for the deaf, and over 50 teachers whose students have emotional problems. Volunteers have also been involved in parent training.
• established two Materials Centers for didactic material in San Jose and Nicoya. The Centers allow for the creation as well as the sharing of materials.
• formed a "taller protegido" (sheltered workshop) for mentally retarded adults, thus aiding their integration into the labor force;
• helped coordinate summer programs for disabled children on vacation;
• created a special resource room with a capacity for 30 slow learners in a banana plantation region. A Costa Rican teacher will be continuing the project after the volunteer leaves.
• established an infant stimulation program for physically handicapped children in Nicoya;
• assisted in the creation of two bilingual kindergartens and trained teachers who will carry on the class;
• contributed to curriculum development in special education classes attached to regular schools;
• developed and integrated a physical education program into the special education curriculum;
• translated many special education materials into Spanish;
• diagnosed learning problems of children in four schools.
Audio-Visual Handicap Prevention
The Audio-Visual Handicap Prevention Project assigns volunteers to work as audio-visual health promoters with health personnel in rural health posts. They are involved in community consciousness-raising about health issues, organize community associations' work toward the prevention of blindness and deafness, and collect data on handicaps for studies. Volunteers also provide periodic lectures on vision and auditory care, parent education for home testing and early stimulation, orientation to teachers on audio-visual examinations, and evaluation of the program for the prevention of blindness and deafness. Additionally, volunteers follow up high risk cases and evaluate the overall program effectiveness of projects dealing with the prevention of blindness and deafness.
III. SUMMARY COMMENTS
Costa Rica clearly has one of the most developed national programs addressing the needs of the disabled of any country in which Peace Corps works. The country has become a training ground for special educators throughout Central and South America and selected placements of highly skilled volunteers can thus make a substantial contribution to special education throughout the Americas. Assignments in vocational development for disabled adults, rural early intervention, and the encouragement of self-help groups of handicapped individuals are appropriate human development assignments for Peace Corps in Costa Rica.
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