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ILO 2015 -- Decent Work Report(Third Edition)

Annex 1
Early historical development of work and employment opportunities for persons with disabilities (1900–1930)

A1.1 Overview

Variations in physical, mental and sensory functioning have always existed among human beings. Yet, people with functional limitations, disabilities, have always run the risk of being excluded and marginalized. Throughout the centuries we have designed and constructed our societies as if persons with disabilities did not exist, as if all human beings can see, hear, walk about, understand and react quickly and adequately to signals from the world around them. This illusion, this misconception about human nature, this inability to take the needs of all citizens into account in the development of society is the main reason for the isolation and exclusion of persons with disabilities, which we can observe in different forms and to different degrees all over the world. It will take a long time to change this pattern of behaviour, which is deeply rooted in prejudice, fear, shame and lack of understanding of what it really means to live with a disability. However, international efforts to improve the living conditions for persons with disabilities have begun and progress is being made. A more systematic effort to improving living conditions of persons with disabilities started long ago in the emerging industrialized nations. During the last 50 years the so-called advanced welfare states have developed comprehensive programmes and services in order to meet the needs of persons with disabilities (UN, 2000).

In the context of work and employment opportunities for persons with disabilities, the starting point was probably about 35 years earlier than that, though there has been a significant acceleration in the pace of change during the past two decades or so. Concepts such as equality of opportunity, justice, rights, choice, recognition and acceptance of diversity, and “reasonable accommodation” (though by another name) are not unique to the independent living movement or the transition to the so-called social and rights models. They can be found in descriptions of the development of vocational rehabilitation, leading to the ability to work, in certain countries at the time of the First World War, 1914–1918. The following paragraphs rely heavily on Harris, 1919.

A1.2 From the beginning

The general depiction of people with disabilities as objects of health, welfare and charity programmes, often resulting in their segregation and exclusion from mainstream activities, including employment, began to be seriously questioned in the early part of the twentieth century. A growing realization that persons with a disability had not only the motivation to work, but the capacity to do so, led to the early development of policies and programmes to enable disabled persons to secure, retain and advance in suitable employment, and to return to work after an absence due to illness or injury. A particular stimulus for the latter, it must be said, was the need for trained workers to replace those called to fight in the First World War.

A1.3 Belgium

In the early days of the First World War, a place of refuge, with medical and surgical treatment for all who needed it, developed near Havre, France, for Belgian soldiers disabled in fighting in their homeland. What soon became known as the “Depot des Invalides” quickly became a centre for medical care and vocational instruction. The curriculum included carpentry, brush making, toy making, plumbing, cooperage, mechanics, wood and metal turning, electrical work, upholstery, shoemaking, tailoring, printing, envelope making and the manufacture of artificial limbs. Wages were paid, some of which was deposited in a savings account to be given to the individual when he left. The advantages of vocationally rehabilitating disabled soldiers to enable them to contribute to the war effort in a supporting role led to the establishment in 1916 of the Ecole Nationale Belge des mutilés de la guerre at Port Villez in France. Training courses included poultry farming, market gardening, office/clerical work, teacher training and over forty technical trades. The school was maintained by the Belgian Government and those attending received the regular rate of army pay plus a portion of the proceeds of the sale of articles produced. For those with the capacity for and interest in studying for a profession such as law, medicine, natural sciences, and so forth, opportunity was provided to study in Paris.

A1.4 France

Vocational rehabilitation and return to work programmes in France had a somewhat similar development to that for Belgian disabled soldiers. The municipality of Lyons opened its first school for this purpose in December 1914, followed by a second six months later. Other municipal authorities, departmental governments, trade unions and private charities followed suit. The Ministry of Commerce adapted vocational schools under its jurisdiction so that soldiers with disabilities could attend. By the end of 1916, over a hundred schools were available for vocational rehabilitation. A National Office was set up the same year to coordinate matters.

“In the larger schools,” according to Harris, “the training offered is divided into instruction in manual trades, office work and general schooling. Figures show that the manual trades most in demand are shoemaking, tailoring, basketry, harness making, saddlery, tinsmithing and carpentry. The reason for the popularity of these trades is that they will afford a living almost anywhere, in the city or in a tiny village. They do not require expensive equipment, and they are the trades selected by the men themselves. Most of the soldiers are from villages and small towns, and these desire to acquire a trade that, when eked out with their pension, will give a good living and yet not be too exacting. These men will open shops in their homes, and have time also to work in the garden, cultivate their tiny farm patches, and attend their vines” (p. 88). Other trades taught included mechanics, typography, lithography, bookbinding, locksmith, brush making, toy making and box-making, welding, mould making and stucco work, vehicle painting, photography, diamond cutting, sabot and galoche making, stone carving, hairdressing, dental mechanics and wireless telegraphy.

A1.5 Great Britain

The aftercare of disabled soldiers and sailors in Great Britain pre-First World War had been principally a matter of private initiative and financial support (Harris, p. 93). State provision consisted largely of a small pension and, where needed, artificial limbs. This approach was changed utterly when an official report in February 1915 stated that primary responsibility in this regard was with government. The report (quoted ibid. p. 95) recommended:

(1) The care of soldiers and sailors should be assumed by the State.

(2) This duty should include:

a) the restoration of the man’s health where practicable;

b) the provision of training facilities if he desires to learn a new trade;

c) the finding of employment for him when he stands in need of such assistance.

The principal pre-war agency of after-care work was the Royal Patriotic Fund Corporation, which held in trust the Royal Patriotic Fund, an amalgamation of private charitable funds, dating back in origin to the Crimean War. The Military and Naval War Pensions Act, 1915 created the Statutory Committee for administration of the Fund, and the Committee and its system of local committees were brought under the control of the Ministry of Pensions when it was established in 1916. The Statutory Committee was, in turn, dissolved under further legislation the following year and the Ministry of Pensions, and Local War Pensions Committees, were charged with “the medical treatment or training for industrial life that a discharged soldier may need”.

Training was provided as needed, in technical schools, agricultural colleges or workshops, though in the case of the last named it was expected that the individual would be employed permanently in the shop. For others, placement was organized through the training institution or local labour exchange. Trade advisory committees were set up jointly by the Ministries of Pensions and Labour in the principal trades for which training was given, to advise “as to conditions under which the training of disabled men in the trade can be best given, the best methods of training, the suitable centres for it, and generally how to secure uniformity in training”. Other local “technical advisory committees” were set up to advise on suitable local schemes for training individuals and the prospects of their employment after training. Both types of committee included equal representation of employers and trade unions. A key characteristic of the British system appears to have been its ability to respond to individual needs and local conditions.

A1.6 Germany

In many ways, at the beginning of the war, Germany was in a better position than many other countries to deal with the issue of vocational rehabilitation. A leader in orthopaedic surgery and rehabilitation, Germany also had a well-developed network of disability centres, many of which had workshops teaching a variety of trades. Employers’ insurance associations also had a number of hospitals which provided services.

It appears that the Government accepted responsibility for the medical rehabilitation of disabled soldiers, while vocational rehabilitation and return to working life were the province of private charity or individual states. As an example, the 900-bed hospital in Nuremberg was made available by the city authorities, complete with up-to-date orthopaedic equipment. General and theoretical instruction was provided in the city’s schools, and practical work in the hospital workshops.

Skills taught included: left-hand writing, typewriting, stenography, commercial courses, farm bookkeeping, decoration and design, office management, tailoring, painting, bookbinding, printing, locksmithing, shoemaking, saddlery, weaving, orthopaedic mechanics, carpentry, farming, blacksmithing, brush making. Additional courses provided in Düsseldorf included telegraphy, electrical and metal work, cardboard and leather-work, plastering, upholstery and dental mechanics.

There were a number of agricultural schools for disabled servicemen, some of which provided training as farm teachers. It was considered that the main need was to equip the small peasant farmer to return to his own holding where, with the help of other family members, he might manage truck gardening, poultry- raising, and so forth.

A number of major employers maintained their own hospitals to rehabilitate former employees disabled in the war and to provide suitable work opportunities afterwards.

A1.7 Canada

The issues of vocational rehabilitation and return to working life for disabled servicemen was a new one for Canada when it arose for the first time in 1915. Having learned what they could of the early experiences of some of the European countries, Canada set about developing its own system to meet its own needs. The authorities concluded at an early stage:

(a) that every case would be an individual one, and should be dealt with accordingly;

(b) that as a matter of fundamental policy, vocational rehabilitation – which they saw as helping an individual to make the transition to civilian employment – should be strictly a civilian and not a military affair;

(c) that, as a motivational factor, it should be made clear that no matter how much an individual might manage to earn following rehabilitation, his status as a government pensioner would not be affected.

As soon as possible after the disabled individual got to the hospital, he was seen by a vocational adviser. If at the end of hospital treatment the serviceman was able to return to his former civil occupation, the vocational work with him was ended. If not, the vocational officer would work with him to ascertain his capacities, experience and inclinations and to hopefully agree a suitable choice of occupation in which there would exist a good prospect of future employment. Assistance with placement was also provided.

Farmers were given special inducements – including homesteads and financial loans in cases - to go back to work on the land. They were trained as tractor and farm mechanics, as creamery workers, in poultry raising and horticulture.

By 1918, the Canadian government was providing training in about two hundred occupations.

A1.8 United States

For some years before the war, there had been growing interest in the United States in vocational education. The Federal Vocational Education Act, approved on 23 February 1917, created a substantial fund to be distributed among the States which accepted the terms of the Act, on a dollar for dollar matching basis, for vocational education. The Act established the Federal Board for Vocational Education to administer the fund and oversee the implementation of the legislation. When the United States entered the war on 6 April 1917, one of the first tasks of the Board was to assist in providing personnel trained for technical war occupations.

When the need for vocational rehabilitation of disabled servicemen arose, the lessons from European and Canadian schemes were studied. There was general agreement that the work of training and returning individuals to civil life was a matter for civilians, not the military. The Smith-Sears Vocational Rehabilitation Bill became law on 27 June 1918. It is interesting to note that the original measure included provision for the vocational rehabilitation of persons disabled at work, as well as those disabled in war. The former was dropped, however, as the President and Cabinet had undertaken to bring no legislation before Congress at that time which did not relate to war measures.

Harris (pp. 173-4) claims that the motivation underlying the establishment of vocational rehabilitation was markedly different as between Europe and the United States:

The work of vocationally rehabilitating the disabled in Europe had its origin in compassion and charity. Its rapid development came through the necessity of using all available manpower and the recognition of the possibility of substituting retrained, but physically disabled men for those yet physically able, but detained behind the lines as workers in essential war industries. Its present status is due primarily to the insistent demands of war work, but partly in addition to the realization by European Governments that there will be a great shortage of trained men in all lines of industry after the war. That country possessing the greatest reserve of skilled workmen, even though in some respects physically disabled, will have a distinct advantage in recuperation over those less favourably situated. With the United States none of the foregoing considerations was the moving cause of the resolution to re-educate for civil life its disabled men, prevented by reason of their injuries from returning to their former means of gaining a livelihood. Indeed, these considerations played small part in the decision, and then only as incidentals of benefit and cause associated with a course already shaping itself upon broader and even higher grounds. That the programme had phases that might rebound to the national good was pleasant to contemplate, but the seeking of a direct national benefit, either as a present or as a post-bellum excuse or reason was never considered as a governing factor.

In brief, the position of the United States, as evidenced by its legislation on the subject of vocational rehabilitation for disabled soldiers and sailors, is that the Nation owes them neither charity nor alms; that their sacrifice and service deserve more than a gratuity; that the Nation is in fact indebted deeply to them, and under the highest moral obligation to discharge its debt fully and generously; and that complete restoration to pre-war civil status is a matter of simple justice to the men who have been disabled and handicapped by reason of their service in defending the commonwealth against its armed foes.

As further explanation of what he saw as the philosophy underlying the United States approach, Harris was extremely critical of the “obsolete pension system” and its “pernicious effects upon the pensioners and the public, and upon legislation and politics”, arguing that “restoration and restitution, including such compensation as might be necessary to accomplish these objects and the establishment of equality of opportunity was the course to be followed” (op. cit. p. 174).

As in Canada, the United States provided vocational advisers to assist the individuals in career decision-making, “the primary endeavour (being) to fit the individual man for the job for which his inclination and capacity seem to indicate the strongest probability of success, scientifically adjusted to the likelihood of there being a demand for his services in the line of work selected” (op. cit. p. 217).

It was recognized that prejudice against hiring persons with disabilities existed among many employers. Special programmes to help reduce or eliminate it were launched as part of the placement and follow-up effort. Trade unions supported the policy of vocational rehabilitation in the United States, as they did in Europe.

Harris records, in an early example of reasonable accommodation, that “. . . where special appliances, safeguards or equipment are required as means of overcoming special handicaps, these must be provided under fair agreements with employers, and some supervision after placement will be necessary to insure the proper carrying out of such agreements” (op. cit. p. 241).

As the war ended, legislation to extend the provisions of the vocational rehabilitation system to persons acquiring a disability in the workplace was being introduced.

A1.9 Women with disabilities

The legislation and systems described above were designed with disabled servicemen in mind. Little attention, if any, appears to have been given to the vocational rehabilitation needs of women who acquired disabilities during the First World War, presumably because relatively few service-women served in the front line. That work opportunities for women with disabilities was an issue of concern, at least in the United States, might however be gleaned from research reports such as Eaves (1921), which examined vocational guidance and placement approaches for a thousand women in Boston, many of whom had disabilities of varying kinds.

A1.10 Period of stagnation

The issue of vocational rehabilitation and work opportunities for persons with disability largely faded from political agendas during the economic depression of the 1930s, emerging again during the Second World War, with quota systems forming a large part of the response in many cases.