Asia Pacific Regional EGM - Country Paper from Cambodia

Legislation, Policy and Programmes Concerning the Rights of People with Disabilities

Country Profile - CAMBODIA

(Draft)

Introduction
General Situation
Review of Legislative and Policy Framework
1. Disability Legislation
2. National Policy
  1. Mandate of the Government
  2. Formal Obligations of the Government
  3. Moral Obligations of the Government
  4. Disabilities Public Awareness
  5. Disabilities Awarness
  6. Accessibilities and Communication
  7. Education
  8. Training and Employment/Micro-enterprise
  9. Commnity Work with Disabled People
  10. Physical Rehabilitation and Assistive Devices
  11. Self-help Organizaiton
  12. Recreation, Sport and Cultural Activities
Conclusion/Analysis
Recommendations

I. Introduction

1. Cambodia like most countries in the world is trying to adopt policies focusing on equality and right of disabled in the society. Yet, the legislation on the rights of people with disabilities has not adopted.

2. After more than two decades of war, over ten million anti-personnel landmines and unexploded ordnances (UXO) have been left in Cambodia, which have killed and maimed thousand of children, women and men. Although mine awareness and clearance activities conducted by the Cambodian Mine Action Centre (CMAC[1]) and several other non-governmental organizations, hidden-weapons still continue to kill and maim Cambodians everyday. The statistics from the Cambodian Red Cross reveal that from 1979 to June 1999 an average of 200 Cambodians a month had been maimed. The injuries caused by landmines continue and approximately 60 people are injured each month. The majority of these lose at least one limb. It is also estimated that there are approximately 45,000 amputees in Cambodia, or one in 226, the highest number in the world caused by this dreadful weapon alone. Based on the most recent finding, a survey in Cambodia made by United Nations and Disabled Persons[2] estimated that people with disabilities comprise about 1.4 million or 15 percent of the total population of Cambodia.

3. However, it should be noted that all figures[3] provided for disability are estimates. To date there has been no single satisfactory study that provides an accurate figure for the number of people with disabilities in Cambodia, and a variety of different studies have provided these different figures. This is in part due to the inadequate registration of people with disabilities and all figures should therefore be viewed with caution.

II. General Situation

4. Disabled persons are perceived in Cambodian culture and Buddhist religion as social handicaps. The loss of physical or mental capability is regarded in relation to the individual's destiny, and may be considered to be the result of faults accumulated in previous lives. This often results in a sense of guilt and social stigma that increases the exclusion experienced by most persons with disabilities. People with disabilities are marginalized within Cambodia and are often excluded from community development by their own communities. Although there are many NGOs working in the disability sector most are focused on rehabilitation, but do not assist people with disabilities to identify the main causes of their situation, and encourage them to find their own solutions. A sense of hopelessness, loneliness and a lack of affection from families, relatives and friends, compounded by isolation are common problems among persons with disabilities in Cambodia. Even those with the capacity and skills to enter mainstream society are generally not provided the opportunities to do so and often resort to begging, and/or become alcoholics and engage in anti-social behavior.

5. People with disabilities are one of the most vulnerable and poorest groups in Cambodian society. Disabled people are generally the poorest among the poor with very limited access to basic social services, education, skills or vocational training, job placement, and income generation opportunities, thus exacerbating their poverty. Many organisations view disability as a condition of occupational disadvantage that can and should be overcome through a variety of policy measures, regulations, programmes, and services.[4]

6. Disability legislation is the top priority of the disability sector in Cambodia. Legislation is crucial to promote the full participation and equality of persons with disabilities. Rights-Based Legislation emerges from the recognition that people with disabilities have the same rights as non-disabled persons. Therefore, the law must protect the basic right of disabled persons for a life with dignity (ESCAP: Legislation in Equal Opportunities and Full Participation in Development for Disabled Persons, 1995)

7. The need to remove social stigma to allow the full reintegration of people with disabilities into Cambodian society is a long-term issue, which will require a coordinated and global approach. The approach must not only aim to remove the causes leading to disability, but must also strengthen training and work opportunities for persons with disabilities, and increase their social rights, acceptance and dignity. Reintegration must involve empowerment of disabled people so that they may fulfil their own potential and contribute to the rebuilding of their country. Recent government interest in the issue will assist in institutionalising the approach to the reintegration of disabled people. Among persons with disabilities, some groups have been more marginalised than others, including women and girls and children with disabilities.

8. One key factor in the reintegration of people with disabilities is education. Education is a human right and a basic need. However, education in general in Cambodia has suffered greatly from political, social and economic turmoil. The Khmer Rouge Regime was responsible for the almost complete destruction of the education system. Efforts over the past two decades have focused on emergency relief--opening schools and the training and deployment of teachers. It was only towards the end of the last decade that the transition from emergency relief to reconstruction and development began.

9. Education for all persons in Cambodia is imperative. For people with disabilities formal and non-formal education are among the most essential services for child survival and development; education is also a vital means of empowerment and self-help. As a signatory to the UN Convention on the Rights of the Child the Royal Government of Cambodia has a legal obligation to provide education opportunities for children with disabilities. The Ministry of Education, Youth and Sports has made a policy commitment to attain Education for All by 2010. This commitment implicitly covers children with disabilities.

10. It is recognized that education is critical for all persons in Cambodia. The current situation of limited capacity and inadequate resources in the general education system, particularly in rural areas, has resulted in many children being excluded from education altogether, resulting in a high illiteracy rate and low skills. This is particularly the case among children with disabilities, who are the most vulnerable to exclusion. This situation has contributed to a further reduction in employment opportunities for people with disabilities.

11. Cambodian schools and teachers are not equipped to teach children with disabilities. Therefore disabled children are often kept away from school by their parents or are told by their teachers not to attend and their future becomes doubly limited. Their sense of self-confidence and subsequent ability to access services that do exist for them once they become adults will also be limited. This is particularly critical in terms of non-formal vocational and skills training programs, as disabled people with little or no education do not have ready access to the very programs and services designed to help them overcome these problems. It also leaves them dependent on the good will of their relatives and village leaders or on the proactive efforts of community rehabilitation and other development workers to locate them and to find out if they are interested in or able to take advantage of skills training programmes[5].

12. To date programmes to promote education for people with disabilities have been limited to those implemented by NGOs and agencies focusing on children with disabilities. A very limited number of special schools and classes exist, as do some community-based initiatives. Collectively these services only provide education for a very small minority of disabled children and are concentrated mainly in urban areas. The programmes provide almost exclusively for children with physical disabilities and sensory impairments. A very small number of children with disabilities are included into the mainstream education system, as the present school environment does not facilitate their integration.

13. A major factor restricting the full participation and equality of people with disabilities is the prevalence of perceptions and practices that prevent them from functioning as full members of society. Often the abilities of people with disabilities are not recognized. They face social and economic marginalization, discrimination, and have very limited access to resources. Therefore, they find their opportunities for full and equal participation limited. Public awareness, outreach and mass education campaigns, as well as efforts to mobilize the private sector and communities to support the eradication of discrimination, are almost non-existent.

14. Skills training, income generation and job placement are important factors in the rehabilitation of people with disabilities. In Cambodia people with disabilities typically come from the poorest segments of society. For these disabled persons the ability to secure income for themselves and their families is their highest priority. Income generation for persons with disabilities not only contributes a sense of dignity and self-confidence, but is directly linked to poverty reduction and social development.

15. Cambodia’s built environment contains many obstacles for people with disabilities. The majority of public buildings have inaccessible entrances and exists. Toilets are usually located upstairs in small cubicles and never have supporting handles. Some of the larger hotels have accessibility features such as lifts, wide doors and corridors. However most smaller hotels and guesthouses are inaccessible. Problems are similar in hospitals and schools. Higher-level institutions typically have several flights of stairs. Features that should be accessible include entrances, exits, door handles, handle rails, floor surfaces, corridors, toilets, escape routes, elevators, and staircases. External environment barriers include obstructions on footpaths, uneven or no footpaths, street vendors and cars on footpaths, no kerbed ramps, steps, etc.

16. Awareness of accessibility for people with disabilities is minimal outside of organizations working on the promotion of the rights of people with disabilities. However, some adaptations to the built environment and the external environment can be achieved at a minimal cost with creative thinking and careful consideration given to people’s needs. People with disabilities experience difficulties in moving around the numerous obstacles of the built environment on a daily basis. Therefore, people with disabilities and organizations representing them should be consulted from the early planning stages.

17. The prevalence of preventable diseases is often linked to poverty. Poor living conditions, economic situation, family size, the caregiver being the income earner and seasonal shortages of food compound access to health services. Often a lack of money and education prevents people from making decisions to avoid or manage their health problems. Women in some parts of the region have little or no access to basic medical care during pregnancy, childbirth and post delivery. This can lead to risks for mother and child, possible complications and disease and disability. It is estimated that world-wide 10 percent of children are born with or acquire a disability. Children in Cambodia are at risk of disabilities preventable by vaccination, such as measles, neo-natal tetanus and Poliomyelitis. Malnutrition is widespread, often resulting in Vitamin A deficiencies, iodine deficiencies, and other nutrient/protein deficiencies. For some the problems of malnutrition begin before birth thus disadvantaging people early on in life. Tuberculosis too is a public health concern in Cambodia with one of the highest transmission rates in the world, in addition to HIV/AIDs and Malaria.

18. Education, awareness and promotion of protective measures against landmines, traffic and industrial accidents are essential to the prevention of injury or disability. Community-based mine awareness programmes can help to equip people with the information and skills to recognize danger and to minimize the risk of injury due to mines. Reducing the number of weapons and the practice of using weapons is a major step towards preventing accidents that cause disability or death. As the roads in Cambodia improve, the speed at which vehicles travel increases, hence an increase in danger for the motorists, cyclists and pedestrians and a need for education on safety and protective measures. More widespread provision of protective clothing, safety glasses, ear plugs and masks in the workplace would also reduce the risk of job-related accidents and injury.

19. Cambodia became a signatory to the Mine Ban Treaty in Canada on 3 December 1997, and the campaign to ban landmines, at an international level is lobbying for a complete ban on the stockpiling, production and export of mines.

III. REVIEW OF LEGISLATIVE AND POLICY FRAMEWORK

A. Disability Legislation

20. At present, Cambodia has no legislation on disability. Based on recommendations of the Task Force, May 1996, the DAC Legislation Working Group, comprised representatives from various NGOs and MOSALVY, led by the Cambodian Disabled People’s Organization (CDPO), was established to develop a draft law.

21. Following the working draft in the year 2000, a Consultative Working Group was formed with the representatives of ministries, disabled peoples organizations, and people with disabilities. It was then suggested to form an Expert Working Group for redrafting the legislation in keeping with the process of legislation development in Cambodia. The draft was completed and put forward to MOSALVY as the responsible ministry in July 2000 for further consideration and action before submission to the Council of Ministers. The National Assembly and Senate will adopt the draft legislation. The law will give MOSALVY and the DAC responsibility for disability action planning, management of people with disabilities, provision of services for people with disabilities, rehabilitation and employment, and monitoring and inspections in co-ordination and consultation with other involved ministries and organizations. The draft legislation also calls for preparation of sectoral management plans by various ministries in co-operation with MOSALVY and the DAC.

22. A new Working Group is established under the official letter of MOSALVY comprised of four members from MOSALVY, including two senior staff; an Advisor to the Minister; one representative from CDPO; and one from DAC. A Cambodian legal expert was recruited to provide legal and technical guidance during the process. The Working Group was given a mandate to review and revise the draft as well as to follow up with the process until the legislation is discussed and adopted by the National Assembly and the Senate. The work at the Ministry level was completed during the first week of May 2002, and the Group hopes to submit a final draft to the Council of Ministers before the end of 2002. The Legislation is comprehensive, covering specific areas such as quality of life, rehabilitation, health and the prevention of disabilities, accessibility, education, training and employment, incentive programs, elections, etc.(Draft of the legislation is attached as an appendix One).

23. The draft law is designed to be a set of practical approaches to deal with some of the numerous problems facing persons with disabilities in Cambodia. Many other provisions could have been included and some provisions could be strengthened. However, given the very limited human and financial resources of the Government, the proposed draft law aims to be practical and workable. The law will be a first step in a long-term process of developing a law that fits the current situation in the country.

B. National Policy

a) Mandate of the Government

23. The Constitution of the Kingdom of Cambodia states that “every Khmer citizen shall be equal before the law, enjoying the same rights, freedom and fulfilling the same obligations regardless of race, colour, sex, language, religious belief, political tendency, birth origin, social status, wealth and other status”. (section of Article 31 of the Constitution).

b) Formal Obligations of the Government

24. The Government of the Kingdom of Cambodia signed and recognized the following treaties, conventions and declarations. They relate either directly or indirectly to the rights of disabled people.

UN Universal Declaration of Human Rights
United Nations Convention on the Rights of the Child (1989)

25. Since October 20^th, 1994, the Royal Government of Cambodia has become a signatory to the United Nations Economic Social Commission in Asia and the Pacific (UN-ESCAP) Decade of Disabled Persons, 1993-2002 along with a commitment to implementing the World Program of Action Concerning Disabled Persons, UN Resolution 37/52, 1982 and the United Nations Standard Rule on Full Participation and Equality of Opportunities for Disabled Persons, December 1993. The Declaration states that the Royal Government of Cambodia has agreed to adopt the United Nations principles. More particularly, it has thus committed to implement the Agenda for Action of the UN-ESCAP Decade.

c) Moral Obligations of the Government

26. 1981 was declared the International Year of Disabled Persons by the United Nations. At the end of that year the UN adopted the World Programme of Action Concerning Disabled Persons (UN General Assembly, 37^th Session, 1982, Resolution 37/52) during the UN Decade of Disabled Persons (1983 – 1992). The World Programme of Action aimed at the promotion of effective measures for the prevention of disability, rehabilitation and the realization of equal opportunities for persons with disabilities[6].

27. The United Nations facilitated the drafting of the Standard Rules on the Equalization of Opportunities for Persons with Disabilities, which were adopted by the UN General Assembly in December 1993 (48^th Session, 1993, Resolution 48/96). The Standard Rules constitute a set of objectives implying a strong political and moral commitment by the State to take action for the equalization of opportunities for persons with disabilities. They also propose the establishment of a mechanism for the close collaboration between the State, organs of the UN, NGOs and Disabled Persons Organizations.

28. Other moral obligations for State, which partly concern the rights and responsibilities of disabled persons, can be found in the UN Convention on the Elimination of All Forms of Discrimination against Women and the UNESCO World Declaration on Education for All.

29. The Ministry of Social Affairs, Labor and Veterans Affairs (MSALVA), the present MOSALVY has been mandated by the Royal Government to lead and manage social affairs, labor, vocational training, and youth rehabilitation in Cambodia. One of the main tasks of MOSALVY is to prepare guidelines and regulations for the protection and the welfares of Cambodian disabled persons. It also coordinates rehabilitation services for all categories of disabled persons.

30. In 1995, MSALVA initiated a joint ministry-NGO process to develop a National Strategy for the continuation, development and coordination of appropriate programmes and services in the sector. The initiative was called the National Task Force on Disability. A crucial step for the Task Force was the development of fourteen “Guiding Principles” as overall guides for developing a national strategy for the sector. The Task Force determined that adherence to these basic principles would help ensure coordination and forward movement with the sector, and prevent overlap and conflicting programmes that might otherwise develop from 53 separate agencies working with a common target groups.

d) Disability Public Awareness

31. Based on the last survey of disability awareness activity made by DAC, there are nine organizations among 53 organizations surveyed that have been carrying out disability awareness activities, one among them the Cambodian Disabled People’s Organization, which is now suspended most of its activities. The survey assumed that the operational capacity of these organizations is still limited due to the reports, observations, and direct interviews. Many organizations working in the disability sector integrate awareness activities in their programmes by helping their staff, community members, and people with disabilities and their families gain confidence and awareness of rights, abilities and opportunities of people with disabilities in society. Yet these activities are not well coordinated, systematic, or nation wide in their geographic coverage. These activities are also constrained by a lack of human and material resources and a developed capacity to apply appropriate methodologies, design and implement activities and use the media effectively..

c) Disability Awareness

32. Few organizations carry out disability awareness activities. Among those that do engage in awareness raising, operational capacities are limited. There are many organizations that work to address disability and development issues, and disability awareness activities are often integrated into their programs. However, these activities are not always well coordinated, nor are they offered nation wide to provide the necessary geographic coverage. Awareness raising activities face constraints such as limited human and material resources, the absence of a standard methodology to gain media coverage and a higher profile, and geographic concentration. As a result, most disability organizations are limited in their ability to design and implement activities.

33. There is considerable scope to coordinate disability awareness activities in Cambodia at both the national and the local levels. A national coordination committee/working group on disability awareness is still limited by their knowledge, mandate, and responsibility. Coordination of awareness raising activities should be reinforced and designed as a sustainable initiative. There is potentially a strong role for the Cambodian Disabled People’s Organization to support these coordinated approaches

e) Accessibility and Communication

34. Persons with disabilities experience difficulties in moving around the numerous obstacles of the built environment on a daily basis. Therefore, disabled persons and organizations representing them should be consulted on physical accessibility at the early planning stages of any new building or construction project.

35. Awareness of accessibility for people with disabilities is minimal outside of organizations working on the promotion of the rights of people with disabilities. Knowledge of accessibility issues among architects, planners builders and funding bodies is extremely limited. This limited understanding, awareness and respect of disability, in relation to accessibility extends to the wider community. However, adaptations to the built environment and the external environment can be achieved at a minimal cost with creative thinking and careful consideration given to people’s needs.

36. At present the responsibility for building and construction permits is not clearly regulated. Also, the legislation on disability is still in a draft form. Hence, it is difficult at this stage to place responsibility for the implementation and monitoring of accessibility features on government bodies.

37. Currently in Cambodia there are many gaps in the area of communication for people with disabilities but many organizations are looking to expand their services. There is a general lack of availability of assistive devices and tools i.e. hearing aids, Braille machines, speech therapists, etc. Also, there is no certification of sign language interpreters in Cambodia. Khmer sign language is developing; however, it has not yet reached the completion stage. Reading materials in Braille also need to be more available. Schools exist for children with hearing and visual impairments but the current education system of Cambodia does not allow for full access to fully public education with their peers.

f) Education

38. The Government's stated education policy priority is to ensure equitable access and quality improvement for nine years of basic Education for All by 2010. (Draft Interim Poverty Reduction Strategy Paper) This policy was adopted by the Cabinet in late 2000.

39. However, education programmes for persons with disabilities have been implemented solely by non-governmental organizations and focus solely on children with disabilities. A limited number of special schools and classes exist, as do a few community-based initiatives. Collectively their services only provide education for a fraction of children with disabilities in Cambodia, less than one percent. These programmes are concentrated mainly in Phnom Penh and other urban areas and currently cater almost exclusively for children with physical disabilities and sensory impairments. All the special schools have integration in the mainstream as their ultimate goal, but there is no clear policy in this regard.

g) Training and Employment/Micro-enterprises

40. Access to vocational training services and income generation programs is limited by their geographical availability and by the types of services provided. Relatively little is known about the needs in most areas. Numbers and types of disabled persons have not been assessed and local market conditions are more or less unknown. Better co-ordination between service providers could be beneficial for trainees as well as training programmes. Improved coordination would ensure that local labor markets are not flooded and would bring new and needed skills to the local community.

41. The range of employment options after graduation is limited. Currently, the design of most training programs is based on the assumption that graduates will be become self-employed. This is an option for some, but not all graduates. Agricultural training and agriculture-related training for income generation is unknown. Literacy and numeracy training are crucial for self-employment and small enterprise management. However, trainees need to see a clear advantage coming from literacy.

42. Involvement of business people in the planning and implementation of pilot programmes is limited or absent. However, the private sector may eventually become the main employer for those graduates who do not opt for self-employment. Apprenticeship and job placement programmes (which could be paid for by the organization) should be promoted. More work is also needed to dentify potential donors to support small and medium enterprises of disabled persons. Most agencies that support people with disabilities do not have the mandate, financial support or skills needed to manage small and medium enterprise development programs and projects.

h) Community Work with Disabled People

43. Gaps in services for Community Work with Disabled people (CWD) exist both in terms of geographic coverage and in types of services provided.

Geographical Distribution of Services

44. Most CWD agencies are generally working in central, southern and some western provinces. However, they are mainly only working in districts close to the town, and in secure areas with good road condition. It is difficult to gain access to some areas because of lack of security, poor road conditions and large distances. This prevents many people with disabilities living in rural areas from benefiting from programmes.

45. The areas with no access to CWD projects are all former Khmer Rouge areas, such as Krong Pailin, Samlot in Battambang, Anlong Veng in Oddar Meanchey province and Veal Veng in Pursat province,and the northern and eastern areas such as Kampong Thom, Rattanakiri, Mondolkiri, Kratie, Stung Treng provinces. Geographic coverage is still limited to the large cities and towns.

Type of Services

46.Major gaps have been identified in the following types of service:

Access to credit for people with disability: At this moment most CWD agencies are not providing credit to people with disabilities. In the past more agencies provided credit but they have now stopped because of lack of funds for this kind of project. The interest rates of mainstream credit agencies are so high that people with disabilities cannot access credit from them. A further problem is that people in the community often do not allow people with disabilities to join their credit group because they do not trust them to repay the loan to the group.
People with certain types of disability: People with learning difficulty, HIV/AIDS and mental illness and intellectual disabilities do not have access to many income generation and vocational training programs because of the lack of awareness of these kinds of disabilities, and/or lack of knowledge to work with and train people with these types of disabilities.
Skill training for specific groups: Most deaf and blind people living in rural areas do not have basic education or special training such as Braille and signing. They are excluded from mainstream development as well as from skill training provided by agencies in the disability sector. For deaf people, the situation is made worse because most people do not know how to communicate with them.
Employment opportunities for people with disabilities: Most employers are reluctant to employ people with disabilities because they do not meet their criteria due to lack of education and experience.
Skill level of CWD workers: Agencies are using different methodologies in their work with people with disabilities in the community. Some field workers have limited and basic skills in terms of community based work.

47. There is one further area in which the work of CWD sector might be strengthened. This concerns membership of CWD committee. Some CWD agencies are not motivated to send their representatives to this Committee. Some representatives do not come to the meeting regularly because they are very busy with their own work[7].

i) Physical Rehabilitation and assistive devices

48. Gaps in physical rehabilitation services cannot be identified unless members of the physical rehabilitation sector conduct a study to identify these gaps. However, there are service gaps at the community level, that have been identified by stakeholders at provincial and national workshops that. For example, although there are 16 physical rehabilitation centers in Cambodia, service and geographical coverage is not well coordinated. This results in:

Overlapping services, whereby one individual or family received the same service from more than one provider.
Persons with disabilities who live at the remote areas cannot access the rehabilitation center due to lack of information, extension work and referral services; and
Recipient’s behavioral problems in the use of the assistive devices;

j) Self-help Organization

49. Currently in Cambodia there is one recognized self help Organization representing the concerns and interests of people with disabilities. Although based in Phnom Penh, CDPO has begun to give attention to raising awareness and establishing networks and groups of people with disabilities across the country.

50. While this organization and others who have initiated self help groups are networking in many of the provinces, the concerns of rural people with disabilities themselves need to be further addressed.

51. Issues related to distance, bad road conditions, security and lack of support from local authorities have impeded the work of disability organizations and NGOs to support the development of self-help organizations in some parts of the country.

k) Recreation, Sport and Cultural Activities

52. There are few organizations that have considered sport and recreation as programmes and activities to be promoted. It is acknowledged that sport and recreation programmes for PWDs in Cambodia have not been sustainable for many years due to the lack of fund and human resources. Many of these programs are not included in the implementing agencies plans or budgets. Support and contribution of financial resources from government and the general public has not been at levels sufficient to sustain effective sport and recreational programs. There is also a lack of awareness and understanding that sports and recreation are important social activities. However, there is an effort by DAC affiliated organizations and the National Paralympic Committee of Cambodia to facilitate institutional sustainability within certain programmes in the national rehabilitation sector.

IV. CONCLUSION/ ANALYSIS

53. Cambodia’s recent history of war, conflict and international isolation has contributed to the fact that Cambodia is a country with a high number of vulnerable people and high rates of poverty. The poverty profile of Cambodia, based on 1999 data of the Ministry of Planning, indicates that Cambodia is a very poor country with GDP per capita estimated at only US$268 and with other non-income indicators of poverty comparing poorly with those of other countries in the region. It shows that an estimated 35.9 percent of the population is poor and the poverty rate is higher in the rural areas.

54. It is estimated that there are approximately about 1.4 million disabled people in Cambodia, or 15 percent of the total population. People with disabilities are among the poorest of the poor in Cambodia. Recent World Bank estimates suggest they may account for as many as one in five of the world’s poorest.[8] People with disabilities, especially women and children with disabilities, are among the most vulnerable deserving special attention because their standard of living falls far below the poverty line and their capacity for participating in economic activities can be limited by disability.

55. According to the Asian Development Bank, disability can be expected to increase in the future if the economic growth remains unbalanced and does not accommodate equity, environmental factors and social concerns. Increasing poverty leads to increasing of violence and crime as well as to substance abuse, poor environment, traffic accidents and work related injuries—all preventable causes of disabling conditions.

56. Disability is both a cause and consequence of poverty. Eliminating poverty is unlikely to be achieved unless the rights and needs of people with disabilities are taken into account. Disability affects not only the individual, but also impacts on the family and the whole community. The cost of excluding people with disabilities from taking an active part in community life is high and has to be borne by society, particularly those who take on the burden of care. Exclusion of people with disabilities leads to losses in productivity and human potential.[9]

57. Despite many programs working with and for people with disability in Cambodia, there much remains to be done in order to mainstream disability, enhance inclusion of and promote the inclusion of people with disabilities in social and economic development. At the same time, policies and legislation of this regard are still under review. Among the issues that remain to be addressed are[10]:

Rural people, including people with disabilities, have less access to social services such as health, education and safe water. The sector is still institutionally weak, poorly resourced, and lacks operational capacity. Unfortunately, government human and financial resources are still limited, thereby restricting the delivery of basic services to the rural people.
Assistance for people with disabilities, including mine victims, is mainly provided by NGOs. It is clear, however, that current programmes reach only a proportion of those needing assistance, leaving significant needs unmet. Overall co-ordination of assistance in this sector is still limited despite government, NGOs, and donor attempts to promote the work of DAC as a National Co-ordination body.
A persistent feature of national budgets is the weak relationship between budget formulation and budget execution. Additional problems with actual public expenditure outlays include inadequate levels of funding reaching the local level and the leakage of funds in the public expenditure management system.
Hearing impaired and mental health services are in their infancy and inadequate, often lacking focus, manpower and funding. Although there are some services for the visually and hearing impaired and those with mental illness, it is estimated that many thousands of people with disabilities with these conditions have no access to services.
Further disability public awareness campaigns are needed to increase recognition and mainstreaming of people with disability in all socio-economic and cultural activities.
Government policy should be greatly improved mainly via prevention strategies in the early detection of disability, education of people about the need to seek treatment for serious illness (meningitis, septicemia etc), antenatal care, and good birthing care.

IX. RECOMMENDATIONS

58. The analysis of the relationship between disability issues and development led to the identification of four main common areas for strategic action. They are inclusion, participation, access and quality. These four areas for addressing the need for targeted mainstreaming of disability issues in country programming are described as follows:

INCLUSION: People with disabilities must be visible. Inclusion identifies the disability initiatives that need to be taken into account in the design, implementation and evaluation of strategies, policies, programs and projects. Areas to consider are the extent to which disability is supported and included through policies and programs that dedicate financial resources through lending and budget allocations by banking, development, governmental and non-governmental agencies, ensure that material resources are committed to disability issues, ensure that organizations and their personnel are knowledgeable and ensure the accountability of decision makers and program implementers to advance disability issues as a poverty reduction and growth strategy in their area(s) of development.
PARTICIPATION: People with disabilities and their organizations must have a voice. Participation ensures that people with disabilities and their respective organizations are given a voice in decisions that affect their lives and their communities. Strategies to promote effective participation includes consultation and decision-making that involves representatives of people with disabilities including beneficiaries are the priorities.
ACCESS: Removing barriers and creating opportunities to access all services and resources within a community is essential for people with disabilities. Access requires that people with disabilities and other stakeholders are informed and aware of disability issues and have access to available data (i.e. demographics) on disability. It requires that services and resources reach the most vulnerable in rural and urban communities and reach all persons with disabilities, irrespective of age, sex, ethnicity, geography, language and disability. It requires that the built environment and systems of communication are barrier free.
QUALITY: People with disabilities deserve quality of life through knowledge and capacity building. Quality identifies the priority for all sectors and services to be designed and developed according to needs, meet universal standards of practice and be effective. Core dimensions of quality through knowledge is raising the capacity of persons with disabilities and other stakeholders to ensure independent living through technical and functional interventions. It requires the development of critical awareness to influence policy development by increased understanding of the factors impacting on a barrier free environment including community access, attitudes towards disability and human rights, Thirdly, persons with disabilities and other stakeholders need to develop the capacity for social action through the development of skills and experience in participatory management and inter-sectoral and multi-stakeholder approaches to development.

Return to top

[1] Cambodian Mine Action Center

[2] United Nations and Disabled Persons, Bangkok, 1999.

[3] Due to different statistical findings of the disabled population in Cambodia, it’s important to provide in this report the figures from the three sources, RGC, ADB study and UN.

[4] Study on Persons with Disabilities (Cambodia), supported by JICA, DAC Secretariat, Feb 2001

[5] Study on Persons with Disabilities (Cambodia), supported by JICA, DAC Secretariat, Feb 2001

[6] Disability Action Council, Strategic Directions for Disability and Rehabilitation Sector in Cambodia, Feb, 2001

[7] Disability Action Council, Strategic Directions for Disability and Rehabilitation Sector in Cambodia, Feb, 2001

[8] Poverty and Disability, World Bank, October 1999

[9] Disability poverty and development, FIT-February 2000, page 4

[10] Sectoral Paper on Disability and Rehabilitation, NGO Statement to Consultative Group Meeting on Cambodia, Phnom Penh, June 2002