Regional Seminar
An International Convention on Disability
4-7 November 2003, Beijing, China

Cambodia Country Paper

Human Rights of People with Disability
and
Implementation of the ESCAP Biwako Millennium Framework

I. Introduction

Cambodia occupies a territory of 181,035 square kilometres topographically dominated by the Mekong River and the Tonle Sap Lake. It is located in the south-western corner of Indochina with the total population of about 11.4 million and with the annual growth rate of 2.4%. The proportion of female is 51.8%, and children under 15 years old is 48.2%. A large proportion of population (84.3%) lives in rural areas and only 15.7% live in urban areas. Phnom Penh, the capital city, has a population of 997,986[1].

II. Prevalence of Disability

a) Statistical information

Cambodia's recent history of war, destruction of national infrastructure, the breakdown of basic services, the lack of basic health care and food security, the presence of millions of landmines, and the absolute poverty of the majority of its citizens, all contribute to the fact that Cambodia is a country with a high number of disabled people. Base on Socio-Economic Survey of Cambodia, 1996, people with disability constitute approximately 2-3% of the population of Cambodia[2]. The recent survey made by Cambodia Red Cross and Handicap International reveal that one person in 235 is missing a limb(s). In addition, there are also an equally significant number of persons with hearing or sight impairment (35% of total people with disabilities). The vast majority of these disabilities are the result of explosions of landmines or UXO, the legacy of years of political strife. The above total figures of disabled persons have been reported unreliably. A study by the United Nations and Disabled Persons, 1999 estimated the disabled persons comprise about 1.4 million or 15% of the total population. The discrepancy can be explained at least partially by confusion of terms used in identifying disability, unclear definition on disability and its categories, and lack of trained staff on disability who collected data.

b) Situation of Persons with Disability in relation to Fundamental Human Rights

Persons with disabilities constitute the most marginalized group in Cambodia. They are one of the most vulnerable groups and poorest of the poor in Cambodia. For example, 30 per cent of families with heads of household disabled from mines or war are living below the poverty line (while the average of all households is 11.5 per cent).[3] Women and girls with disabilities are excluded from mainstream gender equality programmes. Children and young people with disabilities face overwhelming barriers to participation in education and skill development programmes. Most disabled persons are poor, but few poverty alleviation programmes include provisions for their participation.

People with disabilities have limited access to education, vocational training, employment and income-generation opportunities and other services. Even when services do exist, they are particularly inaccessible to women with disabilities and persons with disabilities in rural areas. For example, almost all of the vocational training centres are situated in Phnom Penh and other cities. Infrastructure is poor and transportation possibilities are limited and expensive for regular traveling both in urban and rural areas. The majority of public buildings, including hospitals and schools, are inaccessible.[4]

Those people with communication difficulties face additional barriers. Deaf Development Programme has developed Khmer sign language and trains teachers. Only some ten people have Khmer sign language teaching skills at the moment. Only two special schools teach sign language for children with disabilities and give day classes to adults. Because almost all deaf people in Cambodia have had no access to any education, are illiterate and do not communicate verbally, they remain one of the most socially and economically marginalized groups of people with disabilities.

Training and employment options for the blind are almost equally limited. The Association of the Blind of Cambodia (ABC) estimates that of 132,000 blind people in Cambodia, approximately 150 can read Braille.

According to the local culture and Buddhist beliefs, disability is the result of “bad karma” and persons with disabilities may be perceived as “bad luck.” Parents feel often ashamed or are overprotective towards their disabled children and do not let them to go to school or participate in social activities. Strong superstitious beliefs are connected to epilepsy, mental illnesses and other disabilities especially in rural areas. On the other hand, Cambodians also believe in good luck resulting from good deeds and charity for poor people. However, this perception has partly lost its meaning due to the civil war and breakdown of society. In general, it is difficult for persons with disabilities to find a job and live independently. Even if persons with disabilities are able to find jobs in the limited formal sector, they face many negative attitudes.[5]

III. Efforts to be taken in Implementation of the Asia Pacific Decade of Disabled Persons and the Biwako Millennium Framework for Action

The Royal Government of Cambodia has adopted and implemented 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. Since October 20^th, 1994, 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 and has recently endorsed the current the Biwako Millennium Framework for Action. More particularly, it has agreed to adopt the UN-ESCAP guidelines on disability. The Royal Government is thus committed to implement the Agenda for Action of the UN-ESCAP Decade and the current the Biwako Millennium Framework for Action.

The Ministry of Social Affairs, Labor, Vocational Training and Youth Rehabilitation (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 of Cambodian disabled persons. It also coordinates rehabilitation services for all categories of disabled persons.

Based on this institutional and policy framework, Cambodia has achieved and is on going to make progress of the following areas:

a) The National Coordination Body

The DAC has been officially formalized through PRAKAS (Ministerial Declaration) issued by the MOSALVY. The current legal status of the DAC has been recognized by the Sub-decree of Cambodian Mine Action Authority (CMAA) under which it is stated that CMAA shall delegate the coordination responsibility on victim assistance to MOSALVY and the DAC. The DAC aims to build national capacity, facilitate the inclusion of disabled needs into the planning cycles of government ministries and civil society, and develop, implement, monitor and evaluate a national plan of action in the disability sector.

To implement the Agenda for the Asian and Pacific Decade of Persons with disabilities and the Biwako Millennium For Action, DAC has developed a plan entitled: Strategic Directions for the Disability and Rehabilitation Sector in Cambodia. The document takes into account the obligations of the Government and aims to coordinate services and It is based on the UN-ESCAP document Implementation of the Agenda for Action for the Asian and Pacific Decade of Persons with disabilities (1993-2002). DAC also develops a three-year strategic plan and one year action plan for the sector.

b) Legislation

One of the major achievements in the disability and rehabilitation sector is the development of a draft Cambodian Disability Law (The Rights of Persons with Disabilities) since 1996, which is now under submission. The current version includes a definition of disability, a principle of financial support for the poorest, accessibility requirements, right to education, right to vote and establishment of a Disability Fund. It is unlikely that the draft law will be ratified until 2003 to 2005. Persons with disabilities were also involved in formulation of the law.[6]

c) Information and Database

Through effort taken by the DAC two types of databases has been developed. Firstly, demographic databases contain information on the types and prevalence of disabilities as well as on the socio-economic situation of persons with disabilities. Secondly, resource databases collect information on services available to persons with disabilities and match the needs of persons with disabilities with these services. Efforts are made to expand existing databases of both types as well as to establish new databases.

d) Public Awareness

At this stage, awareness in disability is increasingly developed in Cambodian society. More persons with disabilities are accepted as employees in the labour market. Disability awareness activity is continued to conduct by several NOGs, including DPOs, using some available media and its community network and resources. The MOSALVY, through Disability Action Council, is responsible in organizing the International Day of Disabled Persons every year on the 3^rd December.

e) Accessibility and Communication and assistive technologies

There are gaps in the area of accessibility and communication in Cambodia, but many organizations are looking to expand their services for visually and hearing impaired persons. There is 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 under development. However, this project has not yet reached the completion stage.

f) Education

To date education programmes for people with disabilities have been implemented solely by non-governmental organizations and focus on children with disabilities. A limited number of special schools and classes exist, as do a few community-based initiatives. Ministry of Education, Youth and Sports (MoEYS) has established a Special Education Office. This Special Education Office has responsibility for developing education opportunities for children with disabilities, girls, minorities, and other vulnerable groups such as street children. Through a joint effort of the DAC, MoEYs, UNICEF and NGOs, an initiative to build a model for Inclusive Education has been underway in one province since the year 2000.

g) Vocational training and employment

There are currently over 16 Local and International NGOs working in collaboration with MOSALVY to implementing programs of vocational skills training, employment and income-generation for disabled persons in Cambodia. However, the range of employment after graduation is limited. At this moment most training courses assume that the graduates will be become self-employed. This is an option for some, but not for all graduates.

h) Prevention of Causes of Disabilities and Medical Rehabilitation

As Cambodia has recently emerged from the prolonged war and conflict, the lack of basic health care, malnutrition, bad hygiene, landmines and poverty have been regarded as serious causes of disabilities in Cambodia. On the other hand, it is reported that disabilities caused by traffic accidents are increasing. However, efforts to prevent landmines injuries is continued in a broad extend. The Ministry of Health is also developing training for primary health care service provides primary health care package for operational districts (PHC packages) and a Minimum Packages of Activities (MPA) for preventative, promotional, curative medicine. Polio related paralysis now could be prevented by adequate immunization coverage of all children under five. WHO and MOH are working hard on the program to attempt to reach out to all children under five. In their last National Immunization Day, coverage was close to 100 percent. If this achievement continues, then it is predicted that in five years times, polio will be eradicated from Cambodia. This would help prevent 0.2 percent of all disabilities attributable to polio

i) Rehabilitation

The MOSALVY has primary responsibility for programmes and services affecting persons with disabilities, including physical rehabilitation. The Ministry of Health (MoH) and the Ministry of Education, Youth and Sports (MoEYS), also administer programmes and services with significant impacts on persons with disabilities. Given the severe limitation of financial and human resources, the government is in no position to provide the kinds of services and programmes needed by this large population of persons with disabilities, but the government provides supports and collaborate with IOs and NGOs in this area.

j) Self-help Organization of Persons with disabilities

Currently in Cambodia there is one recognized Cross-disability membership, Self Help Organisation (SHO) representing the concerns/interests of people with disabilities being the Cambodian Disabled People’s Organization (CDPO) and few other specific groups SHO that word towards addressing the interests of the groups. CDPO works with MOSALVY and the DAC at the policymaking and coordination level.[7] CDPO is currently undergoing restructuring and will become operational again soon.

k) Women with Disabilities

Disability Action Council provides a forum for the Women with Disabilities Committee to support disabled women working across the sectors, for discussion on relevant issues, and network development. Its task will be to work through represented agencies, and other relevant bodies, disseminating information on the current status and needs of women with disabilities, raising awareness, and promoting equitable participation of women with disabilities in all services/resources and activities.

l) Regional Cooperation

The DAC has a close relationship with ESCAP and has become a member of the Regional Inter-Agency Committee for Asia and the Pacific-RICAP and the current TWGCD Sub-Committee on Disability-related Concerns.Representatives from DAC affiliated member organizations and secretariat have participated regularly in regional workshops, meetings, conferences and other events on disability-related issues, held in the region.

IV. Barriers and gaps

Within Cambodia, there have been many advances in opportunities for people with disabilities as the country continues it rehabilitation process after years of conflict. However, many serious gaps and barriers exist:

Lack of disability rights legislation and policy support for the protection of the rights and the inclusion of people with disabilities in mainstream services.
Accurate, comprehensive data is deficient both from a national perspective and with regard to the participation of people with disabilities in certain types of programs.
While efforts to provide for and include people with disabilities in education programs is beginning, people with disabilities do not have equitable access to education and therefore advance to higher levels of training.
The public buildings including schools and hospitals are often inaccessible to people with disabilities.
People with disabilities are the poorest of the poor and often cannot afford training fees or accommodation and transportation costs.
Accessibility and transport present additional barriers.
Employment services, including guidance, job placement, etc. are limited for all Cambodians.
Since Cambodia is largely an agrarian based economy, land access and use is instrumental especially for many Cambodians in rural areas, where there are few income generation alternatives. Little attention has been paid to the issue of land access and use among people with disabilities.
Lack of access to credit and participation in village based programs due to negative attitudes about people with disabilities.

V. National Future plans

MOSALVY and DAC have developed strategic plans for their future activities in the disability and rehabilitation. In order to carry out the Agenda for Action of the UN-ESCAP Decade of Persons with disabilities (1993-2002) MOSALVY has established the following objectives for the Department of Rehabilitation:[8]

Adopt and implement the Cambodian Disability Law;
Collect disability data and statistics (including training and employment needs) via POSALVY offices and prioritize target areas;
Expand rehabilitation services at community level and establish more rehabilitation centres in provinces (including training and employment needs);
Develop government management capacity of the rehabilitation centres;
Develop physical and mental rehabilitation of people with disabilities through sport and art activities; and
Create job opportunities for people with disabilities by expanding vocational training, encouraging self-employment, increasing the number of disabled civil servants in government institutions and encouraging the private sector to hire people with disabilities.

Recommendations and Immediate Action:[9]

At the disability and rehab sectoral workshop conducted in August 2002, DAC was recommended to undertake the following activities:

Follow up the submission process of the draft Disability Legislation for adoption
DAC Secretariat and ADB project team should go along way together at in co-operative approach to attract the ADB support in the future.
Contact with Regional Rehab Centre in Thailand for further regional co-operation
Deaf education and employment at least 50% for the next decade. It should be put into consideration for next Decade of Agenda
Reformulate the above combined components
Follow up on review and revise ToR of DAC Committees and Working Groups as well as DAC Structure
Revise Strategic Directions for the Disability and Rehabilitation Sector (SDDR) into a 5-Year National Plan based on the agreed areas for action above.
Seek formal approval from the Government on prioritised areas for action for the development of the 5-Year National for the Disability and Rehabilitation Sector in Cambodia.
Facilitate and co-ordinate the DAC Committees and Working Groups to develop and implement their operational plan
Facilitate DAC members and partners' project proposals based on revised SDDR (5-Year National for the Disability and Rehabilitation Sector).

The DAC’s new strategic plan 2002-2005 will focus on three priorities, which are to secure legislation in favor of people with disabilities by 2005, to enable members to deliver integrated and sustainable services for people with disabilities, and to prioritize UN-ESCAP targets for action. A consultative process will be undertaken in order to make difficult choices about which target areas should be prioritized. In addition, the DAC will establish a national database system and simple tools for monitoring, evaluating and reporting on services in collaboration with partners since the third sector (NGOs) must continue to play the main role in service delivery.[10]

In its Strategic Directions document, in the training and employment section, the DAC recommends development and standardization of training curriculums, development of entrepreneurship, and replication of good income-generation models. However, related activities are not fully monitored because of lack of resources. The DAC plans to develop the document into a national plan of the rehabilitation sector, including clear activity plans, responsibilities and timeframes. The national plan would be updated, monitored and evaluated by the Committees of the DAC under supervision of MOSALVY. The DAC estimates that this will take at least two years.[11]

For more information, you are encouraged to visit our website at http: www.dac.org.kh

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[1] National census, 1998

[2] Socio-Economic Survey of Cambodia, 1996

[3] ILO Regional Office for Asia and the Pacific, Generating Decent Work in an Emergency – Poverty Reduction in Cambodia, 2002, p. 26

[4] DAC, Study on Persons with Disabilities in Cambodia, February 2001, p. 15

[5] Interview with Ellen Minotti, Social Services of Cambodia, 21 June 2002

[6] Country Paper on Disability and Poverty Reduction in Cambodia, 2002, p.5

[7] CDPO, Proposal for Consideration by Donor Agencies 2001-2005, 2001, p. 2

[8] MOSALVY, Policy and Strategy on Social Affairs in Cambodia, 2001, p. 35-39

[9] Base on the sector (disability and rehabilitation workshop held on 14 August 2002

[10] DAC, DAC Secretariat Strategic Plan 2002-2005 and Beyond, 2002. p. 5

[11] Interview with Ngy San, Deputy Executive Director, DAC