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Disability and Rehabilitation

This paper is intended to present the future priority needs of the disability and rehabilitation sector in order to get the focus of donors and government for better effective implementation of the Strategy on Poverty Reduction.

   (i)      Introduction

Cambodia has been at the forefront of signing and recognising most of the international instruments relating to the protection of rights and full participation of people with disabilities. These include World Program of Action Concerning Disabled Persons, UN Standard Rules on Equalisation of Opportunity for People with Disabilities, UNESCAP Asian and Pacific Decade of the Disabled Persons 1993-2002, and Biwako Millennium Frame for Action towards Inclusion of People with disabilities in the Asian and Pacific Region 2003-2012.

In order to tackle social development issues, top priority should be given to key areas such as poverty reduction together with pro-poor, sustainable growth and good governance. Poverty reduction and improving the quality of life of all people in Asia and the Pacific has become the overarching objective of the World Bank and the Asian Development Bank (ADB). People with disabilities are among the poorest of the poor in Cambodia, especially women and children with disabilities. They 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.

Investment in programs dealing with disability and rehabilitation has largely come from financial and technical support from outside sources. As Cambodia moves further into the development phase there will be a need for increasing co-ordination, especially between government, local and international non-government organisations, UN organisations, and bilateral and multilateral donors to ensure that investment continues.

The tendency of decreasing funds from donors to help maintain basic services will put an immense strain on the government with its limited resources. 

(ii)      Key Issues

In 2001 there were16 physical rehabilitation centres in Cambodia. However, by 2003 only 12 remain in operation due to the lack of funding. Some donors have changed their priority and others would like to see more contribution, support and ownership from the government. The dilemma this presents is whether an increase in financial support by the government would help in getting more support from donors. A group of NGOs providing physical rehabilitation services has been trying to bring attention to the serious question of the future of services by asking the government to develop a long term plan, sharing financial resources, and review the policy of free of charge services. The concern and commitment are acknowledged but real action is still not fully guaranteed.

At the present time, disability data is not reliable. Official figures from government show that 2 -2.5% of the total population have disabilities. This is very low compared to data from the developed countries which show levels of 10 to 20% or more. Unfortunately there is no common and official definition of disability. Although a number of surveys have been conducted by various agencies and organisations it is acknowledged that socio-economic and demographic data related to disability is far from being consistent and accurate. In addition, the categorisation of disabilities varies from one to another, impeding any comparison, verification, analysis and interpretation of the information, which is very often fragmented and generated from diverse sources. The situation of people with disabilities is not holistically addressed due to lack of centralised, structured and accessible information related to the number of people with disabilities and services provided. This is the main obstacle to any efficient and rational decision-making, strategic planning, monitoring, and evaluation of the intervention to address the situation as well as resource allocation and services.

Cambodian people with disabilities have little to gain from the sameness of treatment concept as long as a range of environmental barriers exist to prevent their social integration. Frustrated with the social welfare approach, Cambodian people with disabilities have begun claiming rights, instead of privilege, to full participation and equality with others in society.

Cambodia does not have separate disability laws at the present, but disability issues have been addressed in some existing Cambodian Laws and Regulations. A Draft Cambodian Disability Law is being developed. The draft law with 70 articles aims to promote integration of people with disabilities into mainstream development programs/activities to ensure the protection and promotion of the rights of all people with disabilities and prohibition of abuse and neglect of these people with disabilities and discrimination against them.

The final draft law (both in Khmer and English) initiated by Cambodian Disabled People’s Organisation (CDPO) has been reviewed and revised by the Legislation Working Group based on inputs and comments from a Cambodian legal experts and senior staff of the Ministry of Social Affairs, Labour, Vocational Training and Youth Rehabilitation. A workshop was organised to get further inputs and views from stakeholders and people with disabilities on the contents of the draft law at the beginning of 2002. MoSALVY established a team of experts to get the necessary documents ready for official submission to the Council of the Ministries. The disability law will help Cambodia to gain reputation in the international arena, assist the government in implementation of policy guidelines as well as provide benefits and opportunities to people with disabilities to participate in the national development to promote wellbeing for themselves, their families, communities, and society.

The Prime Minister and policy makers have always revealed strong support to get the draft law adapted and implemented. Due to the National Assembly Election in 2003 the draft law has been delayed and is expected to be submitted for debate by 2004. People with disabilities are awaiting the adoption of the law and its implementation in the next mandate of the government.

(iii)      Recommendations

The Disability and Rehabilitation Sector would like to raise the following recommendations to:

·         Multi-sectoral collaboration and co-operation efforts are needed to ensure the full integration of people with disabilities. A national co-ordinating body should be further promoted and supported by governments and donors. This will require addressing the lack of access to education, skills training, land, and credit that seems to be acute within communities. Therefore, mainstreaming of people with disabilities into the existing programmes and services means that their natural place as an integral part of society is recognised. 

Recommendations for Government:

·         Include the needs of people with disabilities in the implementation of the National Poverty Reduction Strategy;

·         Develop a long term plan on the disability sector, especially on physical rehabilitation, to prepare appropriate hand over for sustainability of services;

·         Allocate human and financial resources for the sector and ensure the actual disbursement of money;

·         Take action towards the fulfilment of the Biwako Millennium Framework targets in order to promote participation of people with disabilities in mainstream society and in the development process;

·         Work closely with existing national coordinating body (Disability Action Council) and Ministry of Planning/National Institute of Statistics for disability data collection, analysis and dissemination in close consultation with other government ministries and agencies, institutions, disability organisations, and other stakeholders;

·         Insist that the needs of people with disabilities are considered as an integral part of all-planning programmes and projects and not viewed as a separate issue;

·         Ensure that policies relating to disability are actually implemented and check where new policies should be formulated; and

·         Promote and accelerate the passage of the Cambodian Disability Law as part of the efforts to strengthen and protect the rights and interests of people with disabilities and to guarantee their full and equal participation in activities of the community as other citizens.

Recommendations For Donors:

·         Check policies on disability to ensure that policies relating to disability are actually implemented. Where no policies exist new ones should be formulated;

·         Devote and commit for further additional and longer term funding to this sector so that comprehensive planning for the development and implementation of services can be created and implemented by government and NGOs in collaboration and co-operation; 

·         Insist that the needs of people with disabilities are considered as an integral part of all-planning programmes and projects and not viewed as a separate issue;

·         Provide impetus to the fulfilment of the Biwako Millennium Framework targets, especially on disability data collection and use; and

·         Encourage and assist in adoption and dissemination of the Cambodian Disability Law. 

Recommendations for NGOs:

·         Insist that the needs of people with disabilities are considered as an integral part of all-planning programmes and projects and not viewed as a separate issue;

·         Work closely with existing national coordinating body (Disability Action Council) and Ministry of Planning/National Institute of Statistics assisting in disability administrative records and disability data collection;

·         Commit and devote time and resources for communication and sharing of information to the National coordinating body to fulfil the Biwako Millennium Framework targets in order to avoid overlapping and waist of time and resources; and

Assist in disseminating the contents of the Cambodian Disability Law and other disability policies to promote the rights and equal and full participation of people with disabilities in the mainstream development. 

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For more information and the issues raised in this paper, please contact Disability Action Council, Tel: 023 218 797, Email: dac@dac.org.kh