Where Poverty and Disability Meet: Channa's Story

“Before it was difficult running a business while taking care of my children, but now I feel okay. Sometimes I find it difficult or shameful when people ask about Van’s condition, but I’ve gotten used to it.” 

Channa is incredibly candid and open as she shares her experience as a mother, wife, and businesswoman living in an urban poor region of Phnom Penh. On Koh Dach Island, she stands out as one of the few women who is not a silk weaver; she instead runs a small shop selling snacks and everyday products. As a woman caring for a family of five while running her own business, Channa exemplifies the adversity experienced by those who face the intersection of poverty and disability. Her son Van, a vibrant boy of 5 who displays a strong curiosity and intelligence, lives with intellectual and physical disabilities that affect his mobility, speech, and learning. Van loves playing with cars and has a creative mind that motivates him to explore the world in unique ways. However, living with a disability creates significant obstacles for the economic, social, and political participation of the entire family, which often causes or exacerbates life in poverty.

This is not an isolated experience but a systemic one faced by many families in Cambodia who do not have the resources nor the access to proper care. The lack of infrastructure and systems of care for disabled people engenders a vicious cycle between poverty and disability. Despite the passing of a sub decree in 2011 that entitles disabled Cambodians to a monthly pension, less than 4 percent of people with disabilities receive any form of financial assistance from the government. Without proper implementation of healthcare geared towards disability, families like Channa’s are left particularly vulnerable to the devastating effects of poverty. 

Disability as a Determinant of Poverty

Very little exploration has been carried out by researchers as to how disability can cause or worsen poverty. A lack of physical mobility may make it difficult for disabled adults to travel to work or carry out labour-intensive tasks, thus attaining certain higher-paying jobs is not possible. Without proper accommodations, physical or intellectual disabilities in children also make it much more difficult to succeed in or even go to school. The lack of resources and disability training for teachers in Cambodia means that they are often ill-equipped to accommodate children with special needs. 

When I asked Channa about her thoughts on whether Van was going to attend school, she expressed her fear that once Van starts school, he may not be able to keep up, or will not be provided the accommodations required for his unique learning abilities. She states, “I am worried that he won’t make any progress in school and can’t learn. Now he is getting better but just needs more time, as he is not like the other kids.” 

Travelling to school can also be a challenge for children with disabilities. There is only one high school on Koh Dach Island, and as a result some children must travel long distances to reach their education. Physical disabilities that may prevent a child from riding a bike or taking transportation can have a huge impact on their school attendance. The UN estimates that only 44% of children with disabilities have completed primary school in Cambodia, compared to 73% of non-disabled children.* Education is the key to higher income and living standards, and with less access to education, disabled children living in poverty become even further entrapped in its cycle.

The higher costs of living due to additional fees on healthcare services puts a strain on families as well. Channa explains how she is forced to leave the island and pay for a long tuk-tuk ride to the city to reach the Children’s Hospital, which often does not even promise that a doctor will see Van. The understaffing of hospitals and health resource centres means that not everyone is promised treatment, despite spending time and money to do so. This also presents an opportunity cost, as the added time and responsibility of taking care of a disabled family member can impact quality of life and family income, as well as sleep and rest time. Caregivers may also experience the “caregiver burden”, in which they experience psychological and emotional stress or strain from taking care of a family member with disabilities.

A decreased earning capacity due to lack of resources available to those with disability coupled with the higher costs for achieving the same standard of living, results in households being trapped in this “vicious cycle” of generational poverty.

What Can Be Done?

There is much progress to be made to ensure that disabled individuals and their families have the resources and knowledge to both reduce their own poverty and to achieve proper disability care. Having the same opportunities as everybody else is not sufficient; there should be a stronger emphasis on the intersection of poverty and disability in healthcare opportunities, and a focus on disability inclusion in all arenas of social participation. Education is a powerful tool to break the poverty cycle and should be one of the first steps towards reducing poverty in disabled households. Access to healthcare, physiotherapy and occupational therapy, tutoring, and inclusive learning are all areas in need of improvement. 

Despite Channa’s fears, she intends on enrolling Van in school with the hope that he will attain the same level of education as his siblings. Social programs such as those provided by Inclusive Cambodia are helping Van receive regular occupational and physiotherapy, with the goal of improving his independence and increasing potential social and economic participation. When disabled people are given the proper tools and opportunities for social inclusion, they can become actors in reducing poverty for their families and their communities at large.

Informed consent was given for sharing the names and stories documented in this article.

*https://www.un.org/development/desa/disabilities/wp-content/uploads/sites/15/2019/07/disability-report-chapter2.pdf