| Background
Persons with disabilities have been a part of every society since time
immemorial. Thailand is certainly no exception. Given our close-knit family
structure and the care and compassion that is characteristic of communities
in most agrarian-based societies in Asia, these people have generally
been provided with the necessities of life, be it clothing, shelter, food
or medicine. Within this family structure, persons with disabilities were
more often than not mere recipients of assistance ñ however generous
ñ rather than partners in development. And though they may have
been part of a community, they did not enjoy a sense of participation
and equality taken for granted by other members of the society.
The first Thai Law specifically dealing with persons with disabilities
was the Rehabilitation for Disabled Person Act B.E. 2534 (1991). In addition
to protecting the rights of persons with disabilities to rehabilitation
(through among other things, medical attention and education vocational
training), this Act provided for the establishment of a National Committee
for the Rehabilitation of Disabled Persons.
The need to provide special education for disabled or disadvantaged children
was recognized in the National Education Scheme of 1977. The Department
of General Education now runs 41 special schools: 20 for hearing impaired
learners, 2 for the blind and 19 for children with other disabilities.
It also cooperates with private foundations and state hospitals in providing
personnel, equipment and technical assistance to special schools or to
programs for children who are visually impaired, hearing impaired or slow
learners who attend classes in regular schools. Perhaps an even more important
legal document is the Thai Constitution, the highest law of the land.
Adopted in 1997, the present Constitution is the first to make specific
provision for persons with disabilities. Section 30 states that all persons
are equal before the law and shall enjoy equal rights, and it outlaws
discrimination against a person on the grounds of disability. Section
55 states that persons with disabilities shall be afforded access to public
facilities and services while section 80 stipulates that the state should
provide opportunities for persons with disabilities to promote their own
independence, welfare and quality of life.
In line with the Constitution, the Ministry of Education set up 13 Regional
Special Education Centers in 1999 and 63 Provincial Special Education
Centers in 2003 to cover all the provinces in the country. The function
of these centers is to provide rehabilitation for all types of disabilities
and to provide a preparatory program to enable children with disabilities
to attend integrated education programs in regular schools. Because of
the fast expansion of these new centers, their personnel and staff often
do not have sufficient training to provide quality services to children
with disabilities and their families.
An approach currently being adopted is that of Community-based Rehabilitation
(CBR), a system that provides direct services to people with disabilities
in their homes. This approach is essential because not all persons with
disabilities - particularly those living in remote areas of the country
- have access to rehabilitation centers and institutions. It is recognized
that when living in institutions, both children and adults with disabilities
miss out on the benefits of living with their own families. The Ministry
of Public Health, through the Sirindhorn National Medical Rehabilitation
Center, has adopted the concepts and guidelines of CBR from the World
Health Organization (WHO) and customized them to the situation in Thailand.
CBR has been promoted among public health personnel and those in related
agencies since 1992. Responsibility for activities in this field rests
with a CBR Sub-Committee that was established under the Committee for
Rehabilitation of Persons with Disabilities. At present, 5 provinces are
piloting CBR projects, and this number will increase in the future.
Services for visually impaired persons with additional
disabilities
There are no government institutions that provide specific services for
children with visual impairment and additional disabilities, these children
are spread among the 9 Government Social Welfare Homes. These Homes accept
persons with disabilities from birth to old age who are either abandoned,
homeless or who are in dire straits. There are over 4,000 people in the
9 Social Welfare Homes and the number is increasing each year. There are
also visually impaired adults with additional disabilities in these 9
homes who live in separate provision from the children.
The Home for Multiply Handicapped Blind Children of the Christian Foundation
for the Blind in Thailand (CFBT) was established in 1986. Priority was
given to taking visually impaired children with additional disabilities
away from the badly over-crowed Pakkred Home and 45 children were transferred
from this Social Welfare Home to the CFBT Home. In 1988 five small bungalows
were built to afford family-type living with 10 children per dwelling
and a housemother. Food, medical care, physical and emotional rehabilitation
are the primary services needed by this group of children. Their rehabilitation
training focuses on encouraging independence in daily living skills, providing
educational opportunities, and prevocational training. Unfortunately because
of limited space, the Home can accept at the most 65 children. The 20
other children who are currently in the home were either referred to the
Home from the schools for the visually impaired run by the CFBT in the
northeast part of Thailand or were brought directly to the home by parents
or other organization working for the disabled.
The Roiet Early Intervention Program of the Christian Foundation for the
Blind in Thailand (CFBT) is part of their Community Based Rehabilitation
(CBR) Program. The Roiet School for the Blind opened a small classroom
for 10 visually impaired children with additional disabilities and also
makes visits to children who cannot come to the School and are being cared
for by their parents at home.
The Special Education Department of the Rajabhat Suandusit Institute (a
teacher training university) has opened an Early Intervention Center and
children and their parents come to the Center and parents are trained
on how to best help their children. They attend the Center two or three
times a week for half-day sessions. The Early Intervention Center has
expanded its services to accept preschool children with a range of disabilities
including children with visual impairment and additional disabilities.
The limitation of this type of service is that parents who work or do
not have a caretaker are unable to come to the Center.
The Pattaya Redemptorist School for Blind Children provides free residential
schooling for poor blind children. The school has the capacity for training
up to 200 students with a focus on academic education. The school has
also accepted a number of older blind children who have not learnt to
manage independently and younger blind children with additional disabilities.
The school will provide services until the age of 16 after which the students
will be sent home or referred to other centers for the disabled including
the Home for Multiply Handicapped Blind Children and The Lopburi School
for the Blind and the Blind with Additional Disabilities.
The Chiang Mai School for the Blind, also has set up a classroom for visually
impaired children with additional disabilities but stipulates that the
child must initially be accompanied by a parent or caretaker. Last school
year they started a Home School Program, which works with children in
the Chiang Mai province who cannot come to the school.
The Bangkok School for the Blind under the Foundation for the Blind of
Thailand is a residential school for the blind in Bangkok that provides
academic education from Kindergarten to Grade 6. They also provide resource
teachers for blind students studying in mainstream secondary schools.
Some of the students in the school have additional disabilities and this
has forced to the school to open a special class for them that is less
academic focused and more focused on functional skills. This program is
still quite small.
The Lopburi School for the Blind and the Blind with Additional
Disabilities under the Christian Foundation for the Blind in Thailand
(CFBT) The purpose of building this new residential school was
to relieve the over-crowding in the Home for Multiply Disabled Blind Children
and to organize appropriate services for the adult visually impaired persons
with additional disabilities. At the beginning of 2001, 34 visually impaired
persons with additional disabilities who were brought many years ago from
the Social Welfare Homes to the Home for Multiple Handicapped Blind Children
were transferred to the Lopburi School. The Lopburi School also accepts
visually impaired children from six other neighbouring provinces and some
cases referred to them by families living in the north and northeast regions
of Thailand. In 2004, the Lopburi School has 72 students, 60 of these
visually impaired students have multiple disabilities and the remaining
12 children are in a preparatory program to prepare them to be integrated
into regular schools.
The School has two programs for visually impaired persons with additional
disabilities:
1. The Vocational Program has 10 visually impaired adults with additional
disabilities who are independent and do not require additional training
the Rehabilitation Program. The adults who work in this program produce
goods for sale and the profits provide a salary to the students and helps
to raise income to maintain the program. Vocational activities include
producing tie-dyed cloth, mats, key-rings, new year cards, traditional
Thai herbs, and working in inland fisheries, and market gardening. The
adults can participate in most of these activities independently for example
in the production of tie-dyed cloth over 90% of the work can be managed
by the students themselves.
2. The Rehabilitation Program provides services to 50 adults and students
who need to be taught ADL skills, self-help skills and social skills.
These persons also have the opportunity to work part time in the Work
Program.
34 adults with visual impairment and additional disabilities live at the
school. They have no families and are the responsibility of the CFBT.
We have recently started a two-year pilot program with assistance from
the Hilton/Perkins Program of the Perkins School for the Blind to develop
3 Group Homes in the local community near the Lopburi
School, each supported by a sighted supervisor. The adults who are visually
impaired are responsible for cleaning the homes, doing their washing,
assisting with planning meals and cooking, and all the other activities
needed to live independently in the community.
The latest survey (1996) of the National Statistics Office of Thailand
found 1,024,120 people with various types of disabilities. This represents
1.7% of the population of Thailand. 88% of these people (904,540 persons
with disabilities) live in rural areas. By law, only persons with disabilities
who are registered with the government can receive government services
and so far only 392,585 persons are on the register. In Educational Region
6 where Lopburi is located there are 7 provinces with 1,774 visually impaired
persons. In Lopburi province alone there are 5,298 persons with disabilities,
426 of whom have a visual impairment and 239 have multiple disabilities
(including MDVI).
In this area, there is only one school for the blind, so the Lopburi School
has to take many older children who have never been to school and have
not been taught self-help skills. To overcome this problem we have set
up an Early Intervention Program and an Outreach Program to visit families
in the community. Presently there are 88 families being served by our
staff. The Program gives individual family counseling and trains families
in techniques of how to best raise their blind children. One day family
workshops for between 6 - 10 families are also organized for families
to share experiences and knowledge.
To enable persons with disabilities to remain with their families, the
Government in 1997 introduced a monthly family allowance of 500 baht for
each person with a severe disability. This policy has given some help
to families in our early intervention program. Even though it is not enough
it does help to relieve the families of some of their financial difficulties.
Conclusion
There is not yet any government institution that provides quality services
to visually impaired children with additional disabilities. From the above
information, we can see that there are 3 main locations where people with
visual impairment and multiple disabilities (MDVI) can be found:
1. Crowded Social Welfare Homes for the abandoned which have no appropriate
support
for people with MDVI.
2. Regular schools for the blind which have facilities for a few children
with multiple disabilities, but at the age of 16 these children are returned
to their families or sent to the Social Welfare Homes. Even the high quality
programs such as the Rajabhat Suan Dusit and the Northern School for the
Blind in Chaing Mai need to develop stronger transition programs and support
when students leave their programs.
3. The family home, where they are often over protected, and in many cases
cared for by grandparents as their mothers and fathers have had to leave
the rural areas to find employment in more urban areas.
Just a small number of the MDVI receive services. Most visually impaired
children with additional disabilities are cared for at home by families
who often lack knowledge of how to best help them and who are often forced
to leave them at home alone during the day while they go to work. Families
in the community still lack knowledge on the rights of the disabled laid
out in the Thai Constitution Even the Community Based Rehabilitation (CBR)
approach currently being undertaken by the government is still in the
pilot stage and is covering only five provinces.
Nevertheless, services for people with disabilities should gradually improve
as the governmentís CBR program is expanded and as staff in the
Regional and Provincial Special Education Centers become more experienced.
Each year more and more people with disabilities are receiving services
that are being offered through both the government and private sectors.
References:
1. Office of the National Committee for the Rehabilitation of Disabled
Persons, Ministry of Labor and Social Service, Bangkok: 2001
2. Office of the National Education Commission, Education in Thailand
1997, Bangkok: Seven Printing Group, 1997 |