Two friends recently visited me in Cambodia. On our last night together, knowing that I have worked in the Cambodian disability sector for three years, one of them leaned across the dinner table and said: “For a country that’s so poor and with such a recent history of war, I’m surprised that you don’t see more people with disabilities. Where are all the people with disabilities?”
In this country, people with disabilities are invisible.
It wasn’t always this way. Twenty years ago, a flood of money entered Cambodia to establish services that were previously nonexistent. International organisations established centres focusing on physical rehabilitation, which provided much-needed services like physiotherapy and orthoses and prostheses for amputees.
But then things changed. The number of victims of landmines and unexploded ordnance steadily declined, as did donor support for those with disabilities, despite the many other types of disabilities still common in the country.
Indeed, physical disabilities are only the fifth most common type of disability among children, according to a recent Handicap International study. Hearing, intellectual, and speech disabilities are more common.
Today “some services, especially for those with moderate to severe disabilities, are worse now than they were 20 years ago”, said Helen Pitt, founder of Komar Pikar Foundation, who has decades of experience in the Cambodian disability sector.
How can that be? Given the incredible progress we’ve made on other health issues like malaria and HIV, why have services for people with disabilities become worse?
As donor support has waned, the best efforts of those in nonprofit organisations and government have been unable to fill the resulting gap.
There are some extraordinary grassroots individuals and organisations working in this field in Cambodia. It would be easy to point the finger at the Cambodian government, but there are people making positive changes from inside the government as well.
Overall, they are hindered by a lack of resources. The Australian government, by far the biggest donor to disability programs in Cambodia, spends less than a dollar per person with a disability per year. It is not enough.
Too often, those who have the ability to provide resources state that disability is not their priority area. But as long as this mind set exists, too many people will be unable to access education or health care, or participate meaningfully in their community.
We don’t even have a clear picture of how many Cambodians have disabilities. Official statistics change dramatically from survey to survey, with the most current survey stating 2 per cent of Cambodians have a disability, down from 8 per cent in 2009. Yet the World Health Organization (WHO) states that over 15 per cent of the world has a disability.
This discrepancy does not represent extraordinary progress in lowering the disability rate. Given Cambodia’s history and poverty, we have no reason to believe the percentage of people with disabilities in Cambodia is lower than the WHO’s statistic of 15 per cent. Rather, inconsistent data collection methods and a poor understanding of disability at the village level result in a huge variation in statistics.
If official statistics state that two per cent of Cambodians have a disability, then 13 per cent of Cambodian people are invisible. In my experience working with OIC: The Cambodia Project, the most overlooked are people with less-obvious disabilities, such as Ling. A bright boy who slurred his speech, those around the 12-year-old assumed he was stupid.
Ling is one of the estimated 600,000 people in Cambodia with a communication or swallowing disorder, most of whom are unable to access the health services they need.
Fortunately, Ling’s community worker received training on therapy for communication disorders, and she helped Ling improve his speech so much that he was able to form full sentences and be understood. Ling was able to attend school for the first time, where he is now second in his class.
Ling shows us that by focussing our efforts on the most invisible, we can affect huge change in the lives of those with disabilities. To do this, we need concerted efforts from donor agencies, government bodies and people with disabilities to work together to ensure that people with disabilities do not remain invisible any longer.
We have seen positive change in the lives of many people with disabilities, like Ling, through unified action. The individual stories are encouraging. But there is so much more to do.
The next time a friend visits Cambodia, I hope they are able to comment on how great this country is at including everybody, especially those with disabilities. By focussing our efforts on the most invisible people, we can make this happen.
Weh Yeoh is the founder and managing director of OIC: The Cambodia Project, which aims to establish speech therapy in Cambodia for those with communication and swallowing disorders.