Constitutional provisions of free education and healthcare are pointless for the disabled without accessibility and inclusiveness: Chairman of Disabled Person’s Association
Bhutan on 3rd December observed the International Day of Persons with Disabilities through a program in Paro.
Now, it may come as a surprise, but Bhutan is one of the last 10 countries in the world whose Parliament is yet to ratify the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD).
182 countries of the world and their Parliaments have ratified the convention in their Parliaments committing themselves to the rights and equality of disabled people.
The Convention is a global shift from viewing persons with disabilities as objects of charity, medical treatment and social protection towards viewing them as full and equal members of society, with human rights.
Bhutan like the other 10 holdout countries has signed the convention but it has not ratified it yet.
Policy in place but no legal backing
Bhutan currently has a National Policy for Persons with Disabilities approved by the government in 2019, but the ground reality is that far from the public being aware about it most government agencies are unaware about this policy.
Among people working with the disabled there is agreement that the policy by itself is a very progressive and comprehensive document covering various issues like Education, Health, Economic Sector, built environment, transport, ICT, participation activities, finance, CSOs, human resources, institutional arrangement, monitoring etc. A lot of these are based on the UNCRPD Convention itself.
However, Dr Sanga Dorji who is the chair of the Disabled Persons Association of Bhutan (DPAB) said that the policy, as good as it is, is not binding.
He said that the ratification of the UNCRPD by the Parliament would create a certain incentive and pressure on the system to work on the issue. He said the UNCRPD mandates a country reports its status and activities after 4 years the first time and then every two years.
Dr Sanga said that there has been some misunderstanding by certain stakeholders and also Parliamentarians on the issue.
He said that from the time of the first government itself he heard politicians saying USA has not ratified the Convention and so why should Bhutan do so. He said this is a misunderstanding as the USA already has the American Disability Act of 1995 and has implemented it too.
The USA is also traditionally not keen on ratifying too many conventions given domestic politics. However, the USA is a signatory and there are attempts to get it ratified in their legislative body with the last attempt being defeated by a narrow margin.
Then during the tenure of the second government a process was started to get it ratified in Parliament and that process demanded a high level committee of stakeholders.
Here Dr Sanga said that while most stakeholders supported getting the UNCRPD ratified in Parliament some government agencies including the Ministry of Health interpreted it to mean fulfilling all conditions right after ratification and then they objected as a result of which it did not go to Parliament for ratification.
He said the spirit of UNCRPD is not about immediate compliance, but it is a statement of intent of the country to ensure the rights of the disabled and the reporting of its progress in doing that.
Dr Sanga also highlighted the absence of a Disability Act that would be binding. For example, with no Act there are a lot of government office constructions which are not accessible or friendly to the disabled.
The Executive Director of Ability Bhutan Society, Ugyen Wangchuk said that while the policy is in place and there are action plans and it is incorporated partly into plan activities but the policy at the end is just a guideline.
He said that without the ratification of the UNCRPD and with no Legal Act in place there is no legal basis and no rights based approach.
“What if there is no accessibility in public places but in the absence of an act no one is accountable,” said the ED of Ability Bhutan.
Ugyen said, “I strongly urge the government to look into positively to ratify the UNCRPD.”
He said that with ratification there would be a lot of international agencies that work in the area of disability and Bhutan would get help and resources in this important front.
The Convention has guiding principles like non-discrimination, accessibility, full participation and inclusion, respect for inherent dignity and freedom to make choices, respect of differences and acceptance of persons with disability, equality of opportunity and respect for evolving capacities of children with disabilities
The convention also states that persons with disabilities should be guaranteed the right to inclusive education at all levels, regardless of age, without discrimination and on the basis of equal opportunity.
It covers various other areas like right to health, habitation and rehabilitation services, inclusive and accessible work environment, adequate standard of living or social protection and disaster protection.
Significant number of disabled in Bhutan
The absence of a ratification or an Act is in the backdrop of a large number of disabled people in Bhutan.
The 2017 Population and Housing Census of 2017 said that 2.1 percent of the Bhutanese population suffered from severe to moderate disability.
Dr Sanga here said that the 2017 figure is very conservative as these must only be cases that are physically visible like a blind person or someone on a wheelchair, but a lot of disability cannot be seen with the naked eye during a short survey.
He said the 2005 Population and Housing Census said there was around 3.5 percent of people in Bhutan living with disability.
He said that in fact the World Report on Disability 2011 done by the WHO and the World Bank to give guidance for the implementation of UNCRPD found that 15% of the world’s population is living with some kind of disability or the other of which 2 to 4% face significant difficulties in functioning.
This 15 percent number is also reflected in the Royal Message by Her Majesty The Gyaltsuen on the 3rd December International Disability Day 2020 where Her Majesty said an estimated one billion people live with disabilities around the world.
This 15 percent global figure in the Bhutanese context would mean around 115,000 people living with some form of disability in Bhutan.
If one took the 2017 PHCB survey of 2.1 percent Bhutanese living with severe to moderate disability, then it comes to 16,203 Bhutanese suffering from severe to moderate disability.
Worryingly the ‘Two stage child disability study among children 2 to 9 years’ report of 2010 and 2011 by the National Statistical Bureau, MoH and MoE found that around 21% of children aged 2 to 9 years have at least one disability.
These children are a diverse group and include those with cognitive, visual, hearing, speech, physical and behavioral impairments.
Therefore, according to UNICEF Bhutan, one of the challenges for Bhutan is to ensure that all children with special educational needs and disabilities receive appropriate education and social services.
Constitutional provisions on Education and Health and ground reality for disabled
Dr Sanga said that the Constitution gives various provisions like access to free education and healthcare for all but he said for disabled people it is pointless if there is no accessibility and if they are not inclusive.
He said that in the case of hospitals disabled people can have trouble accessing medical facilities and for those who reach there they find it difficult in terms of communication and other issues. He asked if a help desk could be provided.
Dr Sanga said accessibility is important and accessibility be it physical or otherwise leads to inclusivity.
Dr Sanga said that primary health care is quite good in terms of coverage and so this helps to pick up disabilities in children at an early stage. He said more specialists are needed though.
He said there are different types of disabilities and people maybe familiar with the three main disabilities which are visual, hearing and mobility but there are also others that have to do with communication, the autism spectrum that comes with a wide variety and cerebral palsy.
He pointed to large structures including banks that are not disable friendly and even in terms of meeting nobody shares a soft copy in advance for the disabled.
Dr Sanga said that there is not much awareness in Bhutan on disability but he said that this is not a major challenge for a small community as long as there a few people who can push. He said for example the Education Secretary can send out a circular and it will be sent to DEOs in the whole country and the same applies for the Health Secretary.
He said the challenges lie in the physical and mountainous terrain of the country and limited economic resources. He said in the rural areas more than awareness the issue is financial means and time constraint in looking after the disabled. He said he even heard of cases in rural areas of families tying up a disabled person. He said the family does not want to hurt their member but it is out of frustration and lack of options there.
He said in a place like Thimphu there are around 200 to 300 blind people and there are issues around how they get around and some even have no place to stay with livelihood issues.
He said in terms of jobs while Bhutan does not have job reservations for the disabled, they should not be discriminated against on those grounds.
Disability, Education and the need for the passionate and professionals
The Deputy Chief of the Special Education Needs division Pema Chogyel who himself is visually challenged said currently there are around 20 schools with special education program in 15 Dzongkhags. He said the plan in the 12th FYP is to make it 28 in 20 Dzongkhags and big Thromdes. The program will also provide education support, needs assessment and learning intervention support.
Pema said there is a need to enhance the capacity of teachers, enhance resource mobilization for diverse disability needs, make infrastructure more user friendly and accessible. He said good awareness and advocacy also needs to be created at different levels.
Ugyen Wangchuk said that when one looks at disabilities people tend to associate it only with the physical but he said there are different types of disability including information access. One is when there a Royal Address it is not immediately available to the disabled.
He said there is the issue of both physical and information access to schools although the Ministry of Education is working on certain issues. He said reaching the facility is a challenge for some and then there is the issue of disabilities like Autism Spectrum where there are a different challenges depending on the spectrum. He said there are communication issues for autism and so a general curriculum does not help. He said that teachers need to be trained in fact.
Early intervention in autism is known to be effective in curbing the disability and helping children to cope and become independent.
Ugyen Wangchuk said that a lot of things need to be done. He said there are children who cannot go through the conventional schooling system. He said while for general 18 and 19 year olds they are in college or at the pre university stage but it is a different case of certain disabled youth where even parents leave their jobs to take care of them.
This is where Ability Bhutan calls for early intervention while Draktsho looks at vocational education.
He said there is need for professionals in the field of disability as while CSOs have good community reach their capacity is limited.
He said the need is for service providers and also passionate people even if they are not highly qualified.
He said there is the requirement for speech therapists, occupational therapists and other professionals that Bhutan currently lacks to help children and the disabled.
Ugyen said that in the hospital there is need for more specialists who deal with disabilities like autism, down syndrome and cerebral palsy. This is relevant as early interventions in some of these fields can bring about significant improvements.
Currently there are 6 CSOs working on the issue of disability.
Apart from Ability Bhutan and Draktsho there is NPAB which is focused more on the policy level, Phensem Parents Group formed by parents of disabled children that looks at good practices and support, Bhutan Stroke Foundation for those recovering from stroke and Selwa an organization that will support and complement programs for people with disabilities in Bhutan and looks at coordination at all levels.
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