Caring for the Mentally Retarded in Developing Countries

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Planning services for the mentally retarded in a developing country poses a special challenge, for a variety of reasons. First, there tends to be no clear responsibility for such services on the part of any department or agency. (Correspondingly, documents on mental retardation stress the need for multisectoral collaboration perhaps more consistently than publications on other health-related issues.) In many developing countries health agencies do offer some services for the retarded; the responsibility could, however, with at least equal justification, be given to departments of education or, perhaps, social welfare. The ambiguity concerning who is to take action reflects the ambiguity concerning what one wants to happen with regard to this disorder. Very rightfully, policy documents on mental retardation stress the importance of preventive measures, most of which are outside the scope of activities of the agencies potentially engaged in work with the retarded. They comprise good ante-, peri-, and postnatal care, adequate nutrition for pregnant women and infants, antigoiter measures in endemic areas, and so forth. Here, the agency planning work with retarded persons can only add one voice urging steps that would be desirable for other reasons as well. A second reason for special difficulty in planning services for the mentally retarded is the frequent absence of clear aims. It is obvious that planners often find it difficult to translate enhancement of the physical, mental, and social well-being of the retarded into activities that could serve as goals.