So if you know me well, you know that I have a huge heart for KIDDOS…especially those that might not be fully understood. And for those who dont know me, for the past 7 years, I have worked as a Behavior Specialist and School Psychologist (SP) in different parts of Southern California. Looking back, the path was a natural one in some ways and a culmination of different live events – having epilepsy as a child, having a close friend in high school whom struggled with depression and the suicide of another high schooler (A+ student, affluent, star soccer player) I did not know but whom I was profoundly affected by. Having my own little bout of existential morose, I just could not understand how this world couldn’t see how special and how loved every single person should be and why there were people out there feeling so much internal pain. I have a core belief that everyone has something to offer and I love the thought of the world beaming with 5 billion (or however many people there are on this earth now) authentic human beings. Anyhoo, I could go on and on about my thoughts on this topic but to sum it up, after an experience working in a residential treatment center for adolescent boys, my heart and mind were set ablaze with a need to work in this field.
Fast forward and here I am in Phnom Penh, Cambodia navigating how I can help this population abroad. After one month under my belt, I am just at the very beginning stages of learning how I can get involved in Cambodia and be the most effective with my kind of background. I have come across some really intriguing companies so far such as Skateistan and OIC Cambodia. I have been digging deeper into Khmer services in Cambodia such as TPO and where mental health needs stand on the whole. While doing this research, I have come across a handful of different news articles and journal articles. However, the one that was of particular interest to me was this one from UNICEF by Jennifer Carter. It is quite lengthy but it seems to be a great compendium of information on the current state of services and gives a thorough outline of where we go from here (or from 2009 that is). For those of you whom “nerd out” over this kind of stuff or are just interested in learning more on this topic, I have pulled a few of the most enlightening points made in the article (in my opinion):
- More than 1/2 of disabilities in Cambodia are preventable. Poverty, and a resulting lack of access to health services, represents the predominant cause of disability in the country.
- In line with Cambodia’s population distribution, an estimated half of the disabled population is under 20 years of age.
- In 2011–2012, the Cambodian Ministry of Education with the support of Handicap International conducted an assessment of impairment and disability among 20,000 children and found that 1/10 is affected by a disability, with a majority related to learning skills.
- 36% of Cambodians live on less that 63 US cents per day, many persons with disabilities live on even less
- At present, there is no standardized disability classification system in place in Cambodia. For operational purposes, a 9-category system was developed in order to aid in identifying different disabilities. The nine categories of disability are 1) seeing difficulties, 2) hearing difficulties, 3) speaking difficulties, 4) moving difficulties, 5) feeling difficulties, 6) psychological difficulties (“strange behavior”), 7) learning difficulties, 8) people who have fits, and 9) other.
- In 1989, the World Health Organization (WHO) developed the first manual for practitioners, entitled Training in the Community for People with Disabilities
- Cambodia is predominantly a Buddhist country, with about 85% of the population identifying themselves as Theravada Buddhists. The remaining 15% adhere to Islam, Christianity, Animism, and Hinduism
- “A good deal has been written on the Buddhist perception of disability, but very little in-depth research produced on the subject. Conclusions on the issue of Buddhism and disability tend to be solely based on a belief in karma. Put most simply, it has been argued that Khmer people believe that disability is a result of sin in a past life on the part of the person with the disability or his or her family. A person with a disability is bad luck, someone who should be “left to their fate,” made to pay their karmic debt through a difficult life….. this is a simplified version though. The Khmer world view is complex, influenced by centuries of cultural exchange, shaped by outside forces as well as traditional sources, and above all, dynamic.”
- There is a direct mind-body connection when it comes to health beliefs here. “The seat of consciousness and feelings lies within the jet, or heart- mind. When one is depressed, he or she is plouw jet (literally, road to the heart). When one is kind, lighthearted, or happy, he or she is sobay jet (happy heart). When one is sad, or facing a difficult challenge, he or she is peebahk jet (difficult heart).”
- Due to the Buddhist belief that everyone has a different amount of karmic merit, equality is essentially impossible. Those who hold a higher position have the responsibility of supporting those beneath them, and in doing so they accrue karmic merit. In terms of disability, this may be used as a rationale as to why persons with disabilities beg. They beg because it is expected from them. A wealthy person will give the beggar money and thus accrue merit from a good deed. (Interesting difference from the US where I often feel people assume that homelessness is the fault of the person and if they really “tried hard enough” they could rise above it.)
- In Ratanakiri, community leaders confessed that they did not know the difference between an intellectual and a physical disability.
- Parents of children with disabilities usually go through 6 emotional stages at various points in time: 1. disbelief, 2. guilt, 3. rejection, 4. shame, 5. denial and 6. a feeling of helplessness.
I also pulled a few quotes that may be hard to read but I think are worth sharing. Prefaced though with the lack of education, level of poverty and lack of support there is here, in comparison to the States.
“They call him crazy. When people get angry with him, they torture him and beat him. There are a few people who are nice to him, but most don’t like him. I want encouragement from the community, but people say, ‘If the child dies soon that is good.'” – Mother, Battambang
“No matter how rich a family is, having a disabled child will make them poor.” – Village Chief, Kompong Speu
“The neighbors said that I should give her insecticide so that she will die soon.” – Mother, Kratie
The article emphasized that supporting the family and empowering them to know how to work with their children within the community was a critical element for long-term, success stories versus being dependent on project-oriented, direct care work solely from NGO’s. They call this approach Community-Based Rehabilitation (CBR). She speaks to a multi-dimensional long-term plan which includes details for 4 components: 1) Education, 2) Healthcare, 3) Poverty Alleviation, and lastly 4) Promoting Inclusion in Society. (Starts on page 68 if interested in reading. I won’t go into detail with it as it is very comprehensive and I won’t do it justice trying to summarize.)
This was a long post and perhaps it may sound disheartening in a lot of ways. BUT, the great thing is there are SO many amazing people here, with big hearts, whom are working towards good things. I have begun networking and meeting with some of them. It is pretty invigorating being surrounded by it! While this is just the beginning of my education on working with the special needs community here in Cambodia, I am hoping that by the end of this year, I will have found a place that I can help within one of these four components above.
“There is no greater disability in society than the inability to see a person as more.” – Robert M. Hensel