I have been contemplating several ethical issues in my first few weeks here. I have decided to slowly start posting several of them here. I would, however, like to add in a disclaimer that there are many wonderful things going on in these centers that I am not touching on here. Also, my understanding of the cultural and socio-economic context is still in its nascent stage and with time I may have more thoughts on the matter.
Last week, I had the opportunity to visit seven centers. Each center had a shelter for children among other programs. Some centers were based around the children staying there, others were more focused on community programming and had a shelter as a secondary project. All the shelters had some traffic victims, but most had other types of children too (AIDS orphans; street kids; rape victims; children pulled from their homes because of domestic violence, alcoholism, or poverty; abandoned kids, etc.). There was huge variation in how good they were, how big there were, what resources they had, how the worked with kids, etc. One center in particular was based on the arts and helping children move through their emotions and possible gain employment later. Most of the shelters pushed for the children to either attend local school or a trade school (sometimes with literary classes).
The key similarity I noted was that none of the centers was disability (mobility issues) accessible. One of the smaller shelters could be with very small adjustments. Outside of not being accessible, I did not notice any children with noticeable disabilities. I found out, from one of the other foreign social workers, that all of the shelters have policy to refuse children with disabilities. In fact there are only 2 or 3 shelters in the entire country that accept children with disabilities. This is a huge statement when you think about the amount of landmines still active in this country and the number of children that are maimed by them**. Also, all the centers that are accessible and open to children with disabilities are in the
Phnom Penh. For traffic victims, most of whom come from rural areas, this means little chance of visiting their families or being reintegrated into their community. Furthermore, because they can get more money by begging, children with disabilities are particularly vulnerable to traffickers.
Along the same line, I was consulted about the case of three orphaned children. The basic situation is that the youths, 2 girls (25 and 20) and one younger brother with cerebral palsy, are living in a rural area in extreme poverty. The girls leave their brother at home alone when they go to the rice fields to farm, the organization consulting me deemed this to be dangerous for the brother. However, the field is too far to take him and it provides the food they need to survive. It is too much work for one girl to do alone and because of daylight hours, they cannot work in shifts. The organization had helped them open a small store, but it didn’t make much money and when people came at night and knocked on the door to buy something, the girls were too frightened to open the door. Therefore, in the end, the store did not allow them to reduce their work load in the fields and, thus, spend more time with their brother. In the consultation I was asked if I thought the younger brother should be institutionalized. I said no. Institutionalization, especially in its current state here, could never be considered a good option for the boy. He would not be enabled to learn skills, nor would he get the care that he needs. The woman who was consulting me agreed that it was not a good option for him. But then, what of the sisters?
**According to Lonely Planet
Cambodia, there are still four to six million active landmines strewn throughout the countryside, in rice fields, and along the border. 25-35 people a month are killed by landmines and over 40,000 Cambodians have lost a limb. It is estimated that one out of every 275 Cambodians is an amputee; a rate which rivals few others to be among the worst in the world.