THE PLIGHTS OF BURMA’S DISABLED POPULATION

June 1, 2008

WCRP:

I. A Background on Disability

As of March 2008 the world’s population was estimated to have reached over 6.65 billion1 with between 282 and 608 million of these people classified as disabled, according to World Bank estimates2. Alarmingly people with disabilities make up 15 – 20% of the poor in developing countries (The World Bank)3. There are an estimated 150 million children with disabilities in the world, most of whom live with the reality of exclusion as a result of their surroundings. According to USAID up to 300 million women and girls alone are living with a mental and / or physical disability4, a statistic further confirmed by the World Health Organization (WHO), which claims women with disabilities comprise 10% of all women worldwide.

The population of Myanmar has grown to 56.51 million (ADB)5, with over 60% of the population women and children6. As in previous years at the most recent release of population data the Burmese government omitted information concerning numbers of women and children living with disabilities, although it is widely accepted the numbers at a minimum echo those found worldwide. According to our survey on Koh Dut village in Ye township, Mon State, we estimate that in a population of 6,000 there are at least 10 to 15 disabled children in the village.

Interestingly, there is no specific definition of disability in Myanmar. However, Dr. U Tha Moe, Senior Medical Officer of a hospital dedicated to treating people with disabilities believes by defining the terms ‘healthy’, ‘impairment’, ‘disability’ and ‘handicap’ we can have a better understanding of disability. In the March 2002 Japan International Cooperation Agency Planning and Evaluation department’s country profile on the Union of Myanmar those being healthy was defined as, “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity,” while having impairment may be, “any loss or abnormality of psychological, physiological or anatomical structure or function.” He goes on to discuss being handicapped as having a disadvantage as a result of impairment, or being disabled. The impairment is usually such that the individual is limited or even prevented from being able to fulfill a role that is usually considered normal for that individual, taking into account age, sex, and social and cultural factors. He then finally defines disability as, “Any restriction or loss of ability to perform an activity in the manner or within the range considered normal for a human being as a result of impairment.”7

Similarly, the United Nations (UN) uses those same terms to characterize disability and states that being ‘handicapped’ is quite simply a function of a disabled person’s relationship with their environment. “It occurs when they encounter cultural, physical or social barriers which prevent their access to the various systems of society that are available to other citizens. Thus, handicap is the loss or limitation of opportunities to take part in the life of the community on an equal level with others”8.

II. Types of Disability

As part of their country profile, in 2002 different types of disability prevalent in Burma included learning disabilities, fits, other disabilities, difficulties in moving, strange behavior, numbness in limbs, hearing impairment and visual impairment.9

In Burma, as with other countries worldwide, the origins of a disability may be multifaceted, or begin from any number of factors. These include, congenital diseases or abnormalities, infectious diseases, nutritional deficiencies, lack of immunization, land mines, accidents, poorly or incorrectly administered injections, using expired medication, using incorrect medication and, potentially, eating a lot of spicy foods when pregnant.

Giving examples of common occurrences a in the region, a Ye town doctor told us,

“When a mother gets pregnant she is sometimes issued with the wrong drugs, and eats food that can be detrimental in a pregnancy, including very spicy food. In this case, her child is more likely to be born disabled. After the birth when immunizing their children some doctors provide either incorrect or expired inoculations. When all this is coupled with the types of diseases already prevalent in Burma it is not difficult to encourage a high rate of disability in the community.”

III. Vaccinations

Vaccination programs are run by the government, but by international NGOs who cooperate with the health department’s work on vaccinations including the polio vaccination program even in rural or urban area. Some parents have less awareness of health care issues and therefore fail to send their children to receive their polio immunization. The polio vaccination program has also been linked with directly causing disability, although it is unclear whether it is the injection itself or the result of it being poorly administered. The parents of an 11 year-old paralyzed girl said her illness was caused by childhood vaccines.

“When she was five years old she received her polio vaccination and it was only after that she fell ill and gradually lost all movement in her lower body10.

IV. Land Mines

On the Thai-Burma border, there are frequent clashes between the many different ethnic armed groups, rebel groups and the military junta. In an effort to stop the ethnic and rebel groups the junta launched a military offensive against these groups, using anti-personnel land mines which cause death or serious, debilitating injuries to the innocent people living in the border area.

Among the displaced communities of Shan, Karenni, Karen, Mon, and other ethnic groups in the eastern and southern parts of Burma, land mines and gun battles place much unnecessary suffering and increase greatly the difficulty in caring for disabled people. Despite a five-decades-long civil war in the Thai-border area, there is still no program to care for the victims of land mines across any state or division that borders with Thailand. Land-mines victims and their families have to make their own equipment and prosthesis. Although International NGOs like Handicap International want to work to support land-mine victims in displaced communities, the regime does not allow it. If a disabled person can make the trek to a Thai-border refugee camp they may receive treatment, but basically the life of a person disabled by land mines is grim.

V. Malnutrition

With malnutrition in children linked with developmental and learning disorders, as well as physiological difficulties, the outlook is not good for children in Burma who find themselves in the high risk category. In the Mon Internally Displaced Person (IDP) areas most children face significant nutritional deficits because they are unable to access adequate food supplies from international assistance organizations, and they have to rely on their parents very much. Due to minimal donor assistance many parents are unable to survive on their rations and therefore are forced to work for a meager income that still does little to alleviate their food shortage. Nutrition subsequently takes second place; when the struggle is to buy enough food to fill their stomachs issues of nutritional content are sometimes disregarded.

VI. Being Disabled in Burma

Disabled people in Burma do not have access to a range of support services as in other more developed countries, and employment for a disabled person is unlikely. For this reason disabled people are often reduced to begging, and we therefore only meet them at festivals, bus stations, train stations and other crowded places where money may be given to them freely. If jobs are offered to them they are lowly and poorly remunerated, such as plastic or bottle collecting.

Thus the types of ‘workplaces’ disabled people often find themselves in do little to improve their situation, as diseases run rife on the streets. For women and children especially security may be an issue, and they put themselves in great danger as vulnerable beggars on the streets. Just to survive from day to day a disabled beggar must spend all day begging.

VII. Community response

The vast majority of children with disabilities in developing countries have no access to rehabilitative health care or support services, and many are unable to acquire a formal education (UNICEF)11. In Burma, a lack of formal education regarding disabilities, and a still widely held superstitious belief that disabled persons have been made disabled as punishment for bad deeds in a previous life, leaves disabled people neglected, viewed as abnormal and looked down upon.

Generally disabled people in Burma aren’t treated as normal people; As a result, many disabled people become lonely and have feelings of depression. They feel ostracized from their communities, with few (if any) people trying to help or encourage them. Although some community members will acknowledge and assist disabled people, often the attention they receive is unwelcome, hurtful, or confined to looks and expressions of pity. Bullying is also a major factor facing disabled people in Burma, with name-calling and finding the disabled person a source of amusement commonplace

Some families view their disabled child as a burden, a child that they cannot rely on, nor depend on in the future for income or opportunities. Although many families choose to keep their child and care for them as best they can, some families will go so far as to abandon their child if he/she is disabled.

Where cultural beliefs suggest that to have a disabled child is good luck, and a sign of prosperity for the family, the disabled child is not abandoned. They do not lead a normal life however, and are treated as differently from others in the community.

VIII. Education for Disabled Children

In the Southern part of Burma, it is rare to see special schools for disabled children established and maintained by the government. For children with movement difficulties, strange behavior, and numbness in limbs a regular school is an option, however for children with hearing and/or visual impairment educational opportunities in Southern Burma are non existent.

According to a teacher from the Koh Dut village Mon National School, when disabled student Min Seike Htaw attended the government state school his teachers said that he misbehaved, stole classmate’s property and fought with his classmates frequently. The teachers then forced him to leave. The truth of the situation is very different; Min Seike Htaw was very keen to study and exhibited excellent behavior at the Mon National School his mother sent him to. The teacher went on, “We favored him slightly and ensured he received enough attention to understand what was going on. We encouraged other students not to isolate him. Even though we don’t have special schools for disabled children we welcome all students and treat them equally. We also provide funding for parents of disabled children who cannot afford to pay. We would like all children to access educational opportunities.”

This type of attitude is essential in fostering a healthy educational environment for disabled children. It is costly for the schools however, and can sometimes disrupt classes considerably.

XI. Response of Government and NGOs

According to Burma’s child disabilities law article 18 legislated in 1993,

“1. A child with mental or physical disability (a) has the right to acquire basic (primary level) or vocational education at special schools established by the Social Welfare Department or by Voluntary Social Worker or non-governmental organizations, and (b) has the right to obtain special care and assistance from the state.

2. The Social Welfare Department shall lie down and carry out measures deemed necessary so that mentally or physically disabled children may participate with dignity in the community and with a sense of self-reliance.” 12

Burma signed the Convention on the Rights of the Child (CRC) in 1991 to protect and promote the rights of children in Burma. According to CRC article 23:

“1. States parties recognize that a mentally or physically disabled child should enjoy a full and decent life, in conditions which ensure dignity, promote self-reliance and facilitate the child’s active participation in the community.

2. States parties recognize the right of the disabled child to special care and shall encourage and ensure the extension, subject to available resources, to the eligible child and those responsible for his or her care, of assistance for which application is made and which is appropriate to the child’s condition and to the circumstances of the parents or others caring for the child.

3. Recognizing the special needs of a disabled child, assistance extended in accordance with paragraph 2 of the present article shall be provided free of charge. Whenever possible, taking into account the financial resources of the parents or others caring for the child, and shall be designed to ensure that the disabled child has effective access to and receives education for employment and recreation opportunities in a manner conductive to the child’s achieving the fullest possible social integration and individual development, including his or her culture and spiritual development.

4. States Parties shall promote, in the spirit of international cooperation, the exchange of appropriate information in the field of preventive health care and of medical, psychological and functional treatment of disabled children, including dissemination and access to information concerning methods of rehabilitation, education and vocational services, with the aim of enabling States Parties to improve their capabilities and skills and to widen their experience in these areas. In this regard, particular account shall be taken of the needs of developing countries. “

Although the government legislated their child disabilities law and signed the CRC, they have continually failed to implement any special school education, primary or vocational, in the southern parts of Burma. Disabled persons do not have access to any special care or assistance from the State, with the government effectively ignoring their disabled population by refusing to take responsibility for them. This leaves parents with the great pressure of sole responsibility for their disabled children’s education, healthcare and general wellbeing.

Therefore a disabled person’s quality of life very much depends on the family they were born into. If their living standard is high, a disabled person may live a satisfactory existence as their family can provide accommodation, food and medical treatment. But for those whose living standard is lower, huge problems arise; a non-disabled person struggles in this environment, and a disabled person needs extra care that will not be available to them. Even when partially independent a disabled person is unlikely to find legitimate employment, especially as the government labor departments does not provide any job opportunities for disabled people.

The news is not all bad for disabled people living in Myanmar; some disabled schools have opened, including the School for the Blind (Sagaing), School for the Blind (Yangon), School for the Deaf (Mandalay), Training School for Disabled Youth ( Yangon) and the Training School for Disabled Adults ( Yangon).13

Further, some hospital/rehabilitation centers for disabled persons have opened, including the Eye, Ear, Nose and Throat Hospital (EENT) and the National Rehabilitation Hospital (Yangon), both of which also provide vocational training and house educational facilities for the community. In Yangon and Mandalay there are about ten Non-Government Organisations who work for disabled persons mostly in the fields of medicine and vocational education. Like the government centres, mostly the NGOs only focus on big cities.

In most rural areas, the military government still fails to provide programs or assistance in setting up hospitals or clinics for disabled persons who need treatment. Disabled communities have no treatment locations and are therefore treated in the village with limited medicine and medical professionals. Besides health care, no programs have been supported in rural areas in order to promote education of disabled persons.

According to a recently graduated doctor working at a government hospital, “One of my teachers told me that the government didn’t give any medical assistance to disabled persons in Burma. They have to spend their own money to have medical treatment. If they don’t have money they are unable get any medical treatment. But in Yangon they have schools for the deaf, incapacitated and blind as well as a safe house.

In the southern part of Burma, there are no government hospitals for disabled persons and also there are very few NGOs who work for disabled persons. There is no land mine victims care program in southern Burma.”

Government organizations and public facilities for persons with disabilities include the Ministry of Health (Yangon) and the Department of Social Welfare (Yangon).

There are some local NGOs and also international NGOs are working for disabilities children. Local NGOs include the Disabled Peoples Organization (DPO Myanmar), Eden Handicap Service Center (for children), Myanmar Christian Fellowship of the Blind, Myanmar National Association of the Blind, and The Myanmar Council of Churches. International NGOs include the Association for Aid and Relief (AAR), and World Vision Myanmar.

X. Summary

As with the governmental departments and attempts at aiding disabled people, the base for most of the NGO activity is in Yangon and Mandalay. Disabled people in southern Burma are forgotten and must struggle every day to survive.

WCRP has suggested to International NGOs that along with their health care program, they also need to consider for a specific program to disable persons in providing regular health care and rehabilitation.