3. Current Situation of Persons with Disabilities

3.1 Definition and Classification

In Laos, there is no legal definition of persons with disabilities. However, the definition of PWDs was discussed at the meeting of "Developing a National Strategy for People with Disabilities", 21 February 2000, organized by the Ministry of Labor and Social Welfare (MOLSW).

At the meeting, participants understood the definition of PWDs to be "a person whose ability to perform has been hindered." They also identified the main causes of disabilities as congenital, disease and the consequences of war and accidents.

3.2 Government Policy and National Plan towards Persons with Disabilities

The Government of the Lao People's Democratic Republic has set up a National Committee for Disabled Persons headed by the Minister of the Ministry of Labor and Social Welfare. Committee Board members include the Vice-Ministers of the Ministry of Health, Education and Foreign Affairs, as well as staff from related ministries.

The National Committee pursues measures similar to the Government%acute;s policy for the country%acute;s disabled persons, including the prevention of the causes of disability, free medical care and medical rehabilitation, as well as free professional, social and educational rehabilitation services.

All government ministries and concerned organizations have implemented these measures according to their respective authority and responsibility. They also coordinate and work with each other to implement the measures.

On 21 February 2000, the Ministry of Labor and Social Welfare organized a meeting on "Developing a National Strategy for People with Disabilities". Main topics were to formulate a definition of people with disabilities, identify the problems of disabled people, the disabled population in Lao PDR, and a strategy to involve people with disabilities.

3.3 Government System

The MOLSW deals with disabled persons in regards to vocational training, employment, and caring for people who became disabled due to war and UXO..

Organizations under MOLSW are: 1) Department of Old Veterans and Welfare (at the central level) and 2) Provincial Labor and Social Welfare Service and Old Veterans and Welfare Division (at other levels).

In addition, the MOLSW also cooperates with international organizations in the execution of nationwide clearance of UXO.

Chart 1: Organizational Chart of Ministry of Labor and Social Welfare

Description

Chart 2 : Proposed Plan to 2010

Provincial Committee for Disabled Persons

District Committee for Disabled Persons

Ministry of Education (MOE)

The MOE is responsible for compulsory education of both non-disabled and disabled children nationwide. As per the MOE's authority, all kindergartens, pre-school centers and primary schools must be informed that disabled children are to be enrolled.

Ministry of Health

The MOH handles the following duties to prevent disabilities

1. Carry out an immunization program for children
2. Provide basic health and sanitation
3. Provide a water supply and potable water
4. Carry out an environmental health protection campaign
5. Prevent and combat malaria
6. Prevent and provide tuberculosis treatment
7. Check and provide dermatology and venerology treatment
8. Provide treatment for car/ eye/ nasal/ oral cavity
9. Provide mother and child care
10. Arrange for HIV prevention.

The National Center of Medical Rehabilitation (NCMR) has been assigned by MOH to undertake activities related to persons with disabilities in the areas of treatment and rehabilitation, setting up a rehabilitation system in the country, a workshop operation, handling special schools and vocational training, handling Dermatology and Venerology treatment (Leprosy), and carrying out Community-based Rehabilitation (CBR).

Ministry of Interior

The Department of Traffic Police has been assigned by the MOI to undertake road accident prevention programs on disability. Their duties are as follows:

1. Disseminate traffic regulations, and apply strict measures to traffic regulation offenders and drunken drivers/ riders;
2. Require all persons to pass a driving test before driving;
3. Organize Traffic Regulation Workshops in various schools and offices from time to time.

3.4 Regional Cooperation

Various international organizations and NGOs have provided support and cooperation to the government of Lao PDR in terms of prevention, rehabilitation, and education of disabled persons. Organizations include the United Nations Development Programme, the World Health Organization, the Food and Agricultural Organization, Economic and Social Commission for Asia and the Pacific, UNICEF, UNESCO, United Nations High Commissioner for Refugees (UNHCR), USAID, Japan International Cooperation Agency (JICA), World Vision, World Concern, SCF/ UK, DED, Power and Handicap International.

3.5 Statistics Data

To date, there are two surveys available in Laos regarding persons with disabilities; one by I) the Ministry of Health and Prosthetic and Orthotic Worldwide Education and Relief (POWER) investigating the number of PWDs in 1996, and II) the Ministry of Labor and Social Welfare and Handicap International surveying the social and economic impact of UXO in Laos in 1997. However, the data regarding persons with disabilities was unsatisfactory.

The survey by the Ministry of Health and Prosthetic and Orthotic Worldwide Education and Relief (POWER) was carried out nationwide, approaching almost every town and village in the country. The objective of this survey was to determine the existing number of amputees (arm or leg), due to accidental detonation of mines/unexploded ordnance as well as other accidents, diseases/infections of the bones, cancer, leprosy, or just poverty that was unrelated to UXO or mines.

The survey by the Ministry of Labor and Social Welfare and Handicap International was the first National Survey on the Social Economic Impact of UXO on Lao PDR. According to the survey, there were 5,495 deceased victims; the majority of them, 4,632 cases (84%) died immediately, (11%) while being transported and 269 cases (5%) while hospitalized. The majority of those who escaped death are now living as disabled persons and are a burden for their families.

3.6 Law and Legislation

The government of the Lao People 's Democratic Republic has no specific legislation to protect the rights of people with disabilities. However, the country 's laws and constitution ensure democracy for the entire Lao population. Disabled persons have equal rights as other citizens.

Law and Documents found related to disabled people issued in Lao PDR are as follows.

Laws and Regulations Related to Disabled Persons:

1. Rights of Lao Citizens set in the National Legislation
2. Decree No.18/PMO by the Prime Minister, dated January 27, 1995
3. Decree No. 138/PMO by the Prime Minister on Compulsory Education
4. Labor Law adopted on March 14, 1994
   1. In Group 11 of the Law (Work Accidents) Article 51, Article 52 and Article 53 respectively postulated on Work Accidents Designation, Assistance given to Work Accident Victims and the Allowances for Work Accident Victims and People with Professional Diseases
   2. Group 9 of the Law touches on Income Tax and Social Security Issues; Article 48 covers the Social Security Fund matter
5. Decree 178/PM dated November 30, 1993 on a Social Security Scheme for Government Workers covers issues on the authentication and allowances for amputee personnel. Article 6.1 of this Decree deals with the type of amputation from direct battle effects, other battle servicing activities and executing duty as assigned by organizations as follows

Type Amputation

Class of infirmity	Level of infirmity
Special	81-100%
Category 1	71-81%
Category 2	61-70%
Category 3	51-60%
Category 4	41-50%

The authentication of the amputation categories is determined by the Medical Commission. The allowance is based on the Lowest Salary Level of the Public Service Sector (LSLPSS). There are two methods of giving allowances:

a ) Person with a Disability (PWD) residing in a PWD hostel, an employed PWD and pensioned PWD are granted an allowance as follows

Pension Allowance

Class of Infirmity	Salary	Allowance	Term
Special	100% of his Salary Level	100%	Whole Life
Assisting person allowanced	100% of LSLPSS	None	Whole Life
Category 1	-	40%	Whole Life
Category 2	-	30%	Whole Life
Category 3	-	20%	Whole Life
Category 4	-	10%	Whole Life

b ) PWD who voluntarily returned home and/ or are going to settle in rural areas without accepting a salary and/ or a pension can receive the following allowance:

Allowance for PWDs Voluntarily returned to Rural Area

Class of Disability	Salary	Term
Special	150% of : LSLPSS	Whole Life
Assisting person allowance	100%	Whole Life
Category 1	100%	Whole Life
Category 2	100%	Whole Life
Category 3	100%	Whole Life
Category 4	100%	Whole Life

Apart from this, Article 6.4 also warrants that for amputees wishing to have a prosthetic and orthotic facility, the Social Security Fund will cover 100% of the value allocated by the State. The nationwide implementation of this Decree is carried out through the coordination between the Ministry of Labor and Social Welfare and relevant sectional authority.

6.	Decree on Social Security Scheme for Corporate Employees, signed and scaled by the Prime Minister Sisaved Keobounphang on January 07, 2000.

The social security welfare under this Decree is of compulsory nature for employees working in state-owned, private, and joint-venture enterprises of the industrial, agricultural, servicing sectors and others that employ more than 10 personnel.

This Decree aims to control ten targeted fields. Issues related to PWDs are as follows:

• Health security fund
• Short term allowance fund
• Illness indemnity fund for work accidents and/ or professional diseases
• Long terms allowance fund (pension. PWD, family of deceased personnel).

Article 54 postulates an allowance for work accidents and professional diseases covering the following topics:

• Medical treatment and rehabilitation
• Allowance for temporary loss of working ability
• Allowance for the care giver (attending person)
• Allowance for person with permanent loss of working ability
• Funeral allowance
• Allowance for PWD's Family.

Article 56 states, in respect to a temporary loss of working ability, an employee who has insurance, who takes leave due to a work accident and/or professional disease if taking insurance is entitled to a temporary loss of working ability allowance until able to work again.

Article 58 of Group 8 (Illness due to work accidents and professional diseases) shows the calculation method of issuing the allowance as follows:

• 100% of the salary or wage of an insured employee for the first 6 months
• 60% of the salary or wage of an insured employee for the 7th to 18th month
• Beyond the 18th month, entitled to a permanent loss of working ability allowance; the Ministry of Labor and Social Welfare, and the Social Security Commission Management Board are the responsible bodies to disseminate and be responsible for the implementation of this Decree.

Draft Legislation under Consideration by the National Assembly

The draft legislation under consideration by the National Assembly Commission aims to provide Lao Disabled Persons access to transportation, education, vocational training and employment facilities with the private and governmental sectors

3.7 Social Welfare Support

There is a policy on social welfare support in many areas for disabled people in Lao PDR such as:

1. Providing adequate accommodation
2. Integrating employment in the public service sector
3. Giving attention to the proposal addressed, by disabled persons in order to improve and facilitate the disabled persons employment, their access to Governmental and other buildings, and the use of transportation facilities throughout the nation.

3.8 Medical Services, Rehabilitation and Assistive Devices

The National Center for Medical Rehabilitation (NCMR), Ministry of Health, is responsible for the medical rehabilitation of disabled people. The scheme of tasks includes furnishing rehabilitation technical support to central, provincial service/hospitals and provincial community-based rehabilitation (CBR) programs.

Training technical staff and extending the rehabilitation network to 16 provinces and 6 districts throughout the country have been undertaken.

From 1995, a course on medical rehabilitation was included in the medical studies curriculum at the local university. Medical students studying in the fifth year must attend 60 hours of both theoretical and practical training on medical rehabilitation. Moreover, they have to assist doctors and nurses in providing care for PWDs.

In April 1996, Lao PDR organized a medical conference, aiming 1) to form measures to strengthen the provision of medical rehabilitation services, and 2) to improve the system in providing those services at provincial and district levels. Fifty-six participants who attended the conference were mainly representatives from provincial health service providers and various hospital board directors.

Difficulties of rehabilitation services in Laos are as follows:

• Some families do not believe that rehabilitation is helpful
• The state rehabilitation network for disabled persons has not been able to reach out to the grassroot level yet; so far, it has only been able to perform at the provincial level
• Living in remote areas makes it impossible to access rehabilitation
• Some families think that it is wrong to force a child to take rehabilitation
• Due to poverty, the parents are unable to send a child for treatment and/or long term rehabilitation
• Due to poverty, family members must devote their time to supporting the family which limits their time for a disabled person
• A parent does not know how to assist and train his/her child about basic self-help and rehabilitation (basic physiotherapy).

USAID, World Vision and Power have provided support for assistive devices for disabled persons such as prosthesis and rehabilitation, and artificial limbs'for amputees

3.9 Community Based Rehabilitation

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3.10 Independent Living Movement

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3.11 Public Awareness

Some attitudes towards PWDs in Lao changed after all government ministries, organizations, and provincial offices received a translated report in early 1996, regarding a meeting in Bangkok from 26-30 June 1995 which reviewed progress made by the countries in the Asian and Pacific Region two years into the Asian and Pacific Decade of Disabled Persons.

In September 1996, a Conference on Cooperation for Disabled Persons was held in Lao PDR attended by 24 representatives from the Department of Social Welfare, provincial health services and rehabilitation.

Public awareness was carried out through campaign over information on the prevention of the causes of disability, rehabilitation, and promotion of equalization of PWDs. The publicity campaign included:

1. Broadcasting a television advertisement entitled "Lives are Valuable"
2. Distribution of manuals and posters related to preventing accidents from explosives from the previous civil war, accidents, diseases, and rehabilitation of PWDs
3. Conducting Seminars and training on CBR (community-based rehabilitation) and PHC (primary health care) around the country, and holding charity concerts and musical dances to raise funds and demonstrate the artistic talents of PWDs. All levels of society responded positively to the performances of PWDs

3.12 Sports

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3.13 Prevention

The government of Lao PDR has cooperated with international organizations and NGOs to handle activities to prevent the causes of disability by:

1. a national immunization program,
2. a mother and child health care and protection program,
3. treatment of eye diseases
4. a demining program
5. community-based rehabilitation (CBR) and primary health care (PHC) programs.

Besides, the programs to prevent traffic accidents issues related to narcotics and alcohol abuse have also addressed.

Biwako Millennium Framework Seven Priority Areas

3.14 Self-help Organizations of persons with disabilities and related family and parent associations

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3.15 Early Detection, Intervention and Education

The government has organized special learning and teaching programs for deaf and blind children since 1993. These programs are popular among parents but there is limited capacity of the schools. Not all applicants are enrolled at special education schools. Also, there are not enough dormitories in remote areas for the applicants for special education schools.

Difficulties in education for the persons with disabilities are the following:

• Parents and relatives still do not understand how important education is for their disabled children despite the fact that the Government has adopted a policy of compulsory education for primary school in 1995, with no discrimination between disabled and non-disabled children
• Some families encounter difficulties in sending their children to school due to various circumstances, inconveniences as well as the family's economic situation
• Some parents fear that non-disabled children would tease, bully and possibly harm their child
• Some are too timid to send their child to school
• No access to school
• No school would enroll their child
• The parents, custodians and relatives do not show compassion in supporting their child to study
• No specific school is allocated for disabled persons in their community
• Persons with disabilities are not motivated to study.

After primary education was made compulsory in 1995, according to the Ministry of Education, all schools must accept disabled children like other non-disabled children without any discrimination.

Due to personnel shortage, the Ministry of Education has entrusted:

1. The National Center of Medical Rehabilitation (NCMR) to be in charge of the establishment of a Sigh Language Training School for deaf/hearing impaired persons in Vientiane and Savannakhet.
2. NCMR should be in charge of the establishment of a Braille Letter Training School with the expectation of permitting these disabled children to read and respond to questions within 2-3 years so they can go to grade 4 in a general Primary School in Vientiane Prefecture.
3. Pre-schools and Primary Schools will be built in 8 provinces for persons with Down's Syndrome.
4. Promotion and approval should be given to disabled persons in traditional music and sport activities.

Also an integrated education program has been undertaken since 1993 coordinating with the organization, Save the Childrens' Fund UK.

This program is to support the integration of disabled children into pre-schools, primary schools and lower secondary schools.

In attempt to improve education for disabled people, the government has designed a curriculum for teacher training for disabled children and adults.

3.16 Training and Employment

The provision of professional and vocational training for disabled people involves many requirements and is a big issue for the following reasons:

• The majority of disabled persons are illiterate and/or have little basic knowledge
• No specific vocational training institutions are designated
• No recommendation existed for disabled persons in respect to an appropriate training course that would accommodate them in the labor market
• People still think that PWDs are less competent than non-disabled persons
• The disabled persons movement is still in its baby stage which deprives disabled people the opportunity to show their capability
• Disabled persons are still less dynamic and/or poorly self-motivated
• The Government continuously gives attention to disabled persons and some of the disabled persons have been granted the opportunity to undergo vocational training that has enabled them to be self-supporting. However, disabled persons in this category have been limited in number.

The government approved the establishment of a multi-discipline vocational training center in Vientiane Prefecture, which may increase employment opportunities for people with disabilities. In order to provide job placements that match the skills of persons with disabilities, the Ministry of Labor and Social Welfare has also developed a curriculum of tailoring arts and paper manufacturing handicrafts. A vocational training center soon to be completed will be run by the Sisters of St. Paul De Charter of Thailand. Training courses include computer, accounting, the English language, agriculture, animal husbandry, tailoring and handicrafts. The National Center of Medical Rehabilitation (NCMR) envisages having a multi-discipline vocational training center for deaf persons and providing carpentry, blacksmith, etc. training center if there is foreign financial support.

3.17 Access to Built Environment and Public Transportation

Currently, the Lao People's Democratic Republic still lacks regulations on design, construction, renovation and expansion of buildings to facilitate the movement of disabled persons. There are only design codes and guidelines for general construction and maintenance work. As such, disabled persons cannot easily access public buildings, state buildings, hospitals, schools and roads which are deemed difficult and dangerous for persons in wheelchairs or using crutches.

Due to the increased number of PWDs in society and through a higher enrolment of disabled students in regular schools, teachers can better understand the need for providing accessible classrooms, toilets, and other facilities. Courses on designing accessible buildings have been conducted at the university's architecture faculty. Moreover, issues on accessibility, CBR, and integrated education were raised and discussed by provincial authorities, village leaders, and teachers.

3.18 Access to Information and Communication

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3.19 Poverty Alleviation through capacity-building, social security and sustainable livelihood programs

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