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Vietnam Community-based rehabilitation of children with disabilities: Expanding the idea of community Tran Van Hoang, aged 17, lives with his parents, two brothers and one sister in Ward 15, District 8 of Ho Chi Minh City. Hoang contracted polio when he was one month old and lost the use of his legs. He had also lost the sight in one eye through malnutrition and measles. When the project began, he was spending most of his time inside the house, rarely venturing out. He could not walk at all, not even with his hands. The Community-Based Rehabilitation project referred him to appropriate treatment and rehabilitation services, and also encouraged him to become financially independent. With the exercise from using his new wheelchair, Hoang's body became stronger. He now has an artificial eye, which has improved his confidence in interacting with others. He is often seen in the community now, earning an income by selling lottery tickets. He is supporting his parents – something that is important for any Asian child. “Each of us is marked by the Creator with his destiny. None escapes.” “Be generous to others. One day you will need other people’s generosity.” – traditional sayings Photos: World Vision Vietnam 75
Vietnam Background Community-based rehabilitation works with children with disabilities in-community to promote their safety and quality of life. Discussions with colleagues and key informants revealed that this approach in Vietnam offers documented learning in this significant child protection area. The CAN study 1 showed that public awareness on issues of abuse and neglect appears to be extremely limited and that there appears to be little debate on such issues at any level in the community. A recommendation was that advocates should closely work with programs to ensure true representation of the situation, and that it is necessary for both government and non-government agencies to form active coalitions in order to respond to child maltreatment. World Vision Vietnam, in partnership with the Government of Viet Nam, began responding to issues concerning children in especially difficult circumstances (CEDC) in 1991, and program activities included services for children with disabilities. Key government ministries in the establishment of policies and guidelines to assist children with disabilities included the Ministry of Health, Ministry of Education and Training and the Ministry of Labour, Invalids and Social Affairs. These ministries developed detailed National Plans of Action to support activities for children with disabilities. Communitybased rehabilitation (CBR) was seen as a potentially effective and cost-efficient intervention and was incorporated into these plans. Various agencies, particularly the Ministry of Health, began to develop CBR service programs, focused primarily on children living in rural areas. The Rehabilitation Department of the National Paediatric Institute also played a leading role in the development of CBR in Vietnam. Child protection concerns identified Recognising the special needs of a disabled child, assistance extended…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, training, health care services, rehabilitation services, preparation for employment and recreation opportunities in a manner conducive to the child’s achieving the fullest possible social integration and individual development, including his or her cultural and spiritual development. – Article 23.3, UN Convention on the Rights of the Child In 1997, the Ho Chi Minh City People’s Committee reported that District 4 and District 8 were the two poorest districts in the city. Access to adequate utilities, clean water, legal housing, basic health care and education services was problematic for all residents, and especially for poor families, due to the lack of resources for these services. The 1995 census reported that there were 6,000 “slum-dwelling” families, and approximately 10,000 chronically jobless adults. District 8 includes a major port facility, and many poor families from other provinces continued to arrive in the district looking for work as labourers. However, local authorities reported that the jobless rate continued to increase. In addition, many of these same families were living illegally in the district, making their longterm living situation uncertain. In a 1995 baseline survey, World Vision Vietnam interviewed 300 randomly-selected families of street children in Ho Chi Minh City. 2 This survey revealed that: • 46% of fathers and 54% of mothers interviewed had not completed primary school education • 42% of families had no access to latrines • almost 30% of the caregivers were “single” mothers 1 2 Dorning, K, Crying Out: Children and communities speak on abuse and neglect, World Vision International, 2002 (http://www.wvi.org/imagine/can.htm) Culnane, A & L, Ho Chi Minh City Assistance To Disabled Children, Phase 1 Mid-Term Project Evaluation, unpublished paper, Culnane Consulting International, 2000 76
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Risk Laurence Gray
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Copyright © 2003 by World Vision I
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contents Useful approaches to build
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executive summary responsibility of
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executive summary The Philippines I
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introduction “How is it possible
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introduction Child as a normative f
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introduction • offer opportunity
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introduction information may emerge
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introduction Current challenges of
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introduction Planning long-term for
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introduction Because we are abandon
Page 25 and 26: Cambodia or a medical emergency. Ho
Page 27 and 28: Cambodia This drawing by a child sc
Page 29 and 30: Cambodia near the garbage dump have
Page 31 and 32: Cambodia The Mith Samlanh/Friends v
Page 33 and 34: Cambodia Mith Samlanh/Friends vocat
Page 35 and 36: Cambodia To further understand how
Page 37 and 38: Cambodia Responses were gained thro
Page 39 and 40: Cambodia LICADHO uses a variety of
Page 41 and 42: Cambodia Families are taught to dis
Page 43 and 44: Cambodia The Law Enforcement Agains
Page 45 and 46: Cambodia 3. The project was based o
Page 47 and 48: Indonesia • The BPS also estimate
Page 49 and 50: Indonesia For Children’s Day in J
Page 51 and 52: Indonesia Useful approaches to buil
Page 53 and 54: Indonesia Child protection concerns
Page 55 and 56: Indonesia Children in the IDP camp,
Page 57 and 58: Indonesia building strategies can b
Page 59 and 60: The Philippines • children who ar
Page 61 and 62: The Philippines • conducting a ra
Page 63 and 64: The Philippines increase opportunit
Page 65 and 66: The Philippines Barriers to child p
Page 67 and 68: Sri Lanka Children affected by conf
Page 69 and 70: Sri Lanka Partnership for education
Page 71 and 72: Sri Lanka Children’s play showing
Page 73 and 74: Sri Lanka Impact of the project Som
Page 75: Sri Lanka “I spoke to a group of
Page 79 and 80: Vietnam • At the community level,
Page 81 and 82: Vietnam “States Parties recognise
Page 83 and 84: Vietnam “Talk is cheap. Action is
Page 85 and 86: conclusion Agencies within civil so
Page 87 and 88: ecommendations universities. Advoca
Page 89 and 90: ecommendations • Emerging issues,
Page 91 and 92: acknowledgements Many individuals a
Page 93 and 94: ibliography Amnesty International,
Page 95 and 96: appendix 1 Online toolkit The follo
Page 97: appendix 3 Some principles of World
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