A Case for Public-Private Partnerships: Supporting Iran's Disabled
The situation currently afflicting many in Iran’s disabled community is difficult to say the least. A staggering 400,000 of these disabled individuals—primarily men— are veterans who fought against Iraq during the 1980’s.
These brave ex-servicemen do have support of government agencies like the Social Welfare Organization of Iran and the Iranian Red Crescent Society, along with other charitable and religious organizations. However as time moves on these men’s medical needs will inevitably increase with their age. It is time we rethink how healthcare and funding for these men is provided
Care for the disabled community has primarily been in the hands of the state from the outset the Islamic Revolution of 1979. This top down approach to care was a necessary structure during the first years after the war and while the country was rebuilding itself through the Rafsanjani presidency. However, in recent years the needs of these disabled people have increased considerably, thus putting a strain on the existing medical support structure.
Moreover, the situation in the wider community of those with limited physical ability continues to be burdened under the weight of claimants coming forward with long-term issues seeking adequate care and support over long periods of time.
The State Welfare Organization (SWO) the government body which provides welfare benefits to the veterans, defines disability through four types: physical, auditory, visual, and mental. On the outset, this breakdown seems rather elementary, however the organization role is all-encompassing. The role of the SWO has expanded so much over the years that they must now care for the recently disabled as well as the groups like the veterans. Their budget—like for any organization of its kind worldwide— is finite. To overcome challenges and provide the best care possible, the Iranian government and the SWO must now understand that help can be provided in partnership with the Iranian private sector and international specialists.
Through my company, KTMA, working with the help of occupational therapists in Europe, we have spent two years researching the needs of the physically disabled, while also considering the budgets of the funding authorities. One thing I have found in my time building our company is the lack of support for more than the basics. Yet it is understandable that budgets are limited, and clearly the government, which has helped so many people, needs help itself sometimes.
What Can Be Done
This is where a unique form of public-private partnerships (PPPs) comes in. KTMA has teamed up with both the Social Welfare Organization along with the Red Crescent Society to assess the needs of the disabled and to offer solutions with its growing catalogue of equipment.
The Paralympic Committee of Iran is another worthwhile organization with which we have worked in partnership. They have been invaluable for their excellent understanding of the current needs of the physically disabled. As part of continuing efforts, they also introduced me to one paraplegic veteran whose 24-hour carer was his wife. He shared his story with me.
“Everywhere I go am I with my wife” the man said, adding "I really need more assistance in my daily activities and maybe my wife would like a day off, I hate to be a burden on her."
What surprised me most was that considering the man's severe disabilities, he was still able to get out and about. This is mainly due to the recent introduction of disability access DAF buses by the Tehran municipality. The rest of the help the family receives is either from charitable organizations or from religious groups who help with food and utility costs.
As these caring costs rise further, and Iran's revolutionary generation continue to age, there now is an opportunity for groups like my own, to help in the assistance of the disabled in Iran. However it will take a comprehensive action-plan and cooperation between the public and private sector.
Ultimately this would require the government to overhaul how it distributes its funding for the disabled and those of limited ability. It has been proven time and again that the large state organizations lose effectiveness as they grow, it is just a consequence of the burdens placed upon them. There has been no systematic review of how funding is provided to the organizations and this in itself adds another layer of inefficiency to the system.
Another serious issue afflicting the disabled is the lack of employers willing to take them on. The government did however pass a bill in 2003 that urges large state companies and state bodies to make allowances for the disabled and to get at least a small proportion of them back in to work.
How PPPs Can Help the System
What can, or rather what must be done, is that governmental agencies should relinquish some of their overall responsibilities to third party agencies to carry out specific jobs based on deep expertise. By this method, the country's coffers remain intact and waste which would normally remain in the system would be reduced. The overall quality of care provided to disabled Iranians would also likely increase, as new therapies, equipment, and even personal development opportunities are made available.
Through PPPs we can serve the needs of the disabled by empowering specialized companies to provide for each client’s specific needs.
Moreover, if partially disabled people were able to earn a living, their overall costs are reduced over a period of time. This is particularly advantageous as not only do the financial benefits mean less reliance on the state, but they also give the veterans and other disabled individuals a sense of self-worth, something that many of them have said to me would help their case.
Innovating PPPs to tackle welfare challenges is most achievable. It both helps the state and helps these men and women in many more ways. But the general hesitance of the state to deal with private organizations is holding back the quality of care and service otherwise available. Europe has shown the way in this regard and by learning from their experience we can help Iran’s veterans and disabled people by reorganizing the way these individuals are provided for from the point of first contact.
Photo Credit: Morteza Nikoubazl/Reuters