The Stakeholder Group of Persons with Disabilities, the International Disability Alliance, and others, including CBM compiled a report on the High-level Political Forum and the participation of organizations of persons with disabilities (DPOs) in the Voluntary National Review process. The document entitled Case Study on the Engagement of Organizations of Persons with Disabilities (DPOs) in Voluntary National Reviews showcases the national-level DPO work carried out in different regions as well as best practices and challenges, and includes background information on persons with disabilities in each country. This case study features the volunteering countries of Argentina, Bangladesh, Denmark, El Salvador, Ethiopia, India, Indonesia, Italy, Kenya, Nigeria, Peru, Sweden, and Togo.
CBM was particularly involved in the work carried out in Indonesia and Togo. The CBM country offices in these countries particularly worked with the respective national DPOs to ensure that reports were inclusive of persons with disabilities. The following information is taken from surveys developed by CBM, the International Disability Alliance, and the Stakeholder Group of Persons with Disabilities, as well as directly shared by CBM colleagues in Indonesia and Togo.
I would like to particularly think Risna Utami, our partner from OHANA in Indonesia and Laure Tay, CBM Country Representative of Togo-Benin for their invaluable input and assistance in this process.
The international support and dissemination of information from the global level at the United Nations in New York encouraged local DPOs to better understand and get involved in the VNR process and to increase awareness of the SDGs at the local level for local DPOs. These provided advocacy opportunities for OHANA, a DPO and CBM partner, and other local DPOs to engage in the disability rights movement from the grassroots level. As a concrete outcome from this, persons with disabilities are mentioned once in the main messages report and twice in the full VNR report.
In the main messages report for Indonesia, persons with disabilities are included in the section on disaggregation of data. While disability is referenced, it is in the context of the data being unavailable. In the full VNR report, there are two references of persons with disabilities. The first is related to poverty alleviation through the expansion of social protection coverage, fulfillment of basic needs, and encouraging the improvement of people’s welfare. The second reference is related to families with the lowest socio-economic status having access to basic services. Despite the aforementioned references, inputs from the national disability community were not fully included in the VNR. The reason is because persons with disabilities are considered a “vulnerable group” with separate issues, thus not intersectional in the development sector in Indonesia. Consequently, persons with disabilities are still not viewed as a mainstream issue in the implementation of the SDGs.
Recommendations from persons with disabilities to the national government are as follows:
- Indonesia ratified the CRPD and has formalized the national law 8/2016 on persons with disabilities, therefore it is critical that persons with disabilities are meaningfully included in national SDG implementation.
- Disaggregation of data by persons with disabilities needs to be a priority for the government to implement development programs inclusive of persons with disabilities and to make the rights real for persons with disabilities in line with the SDGs and the CRPD.
- The Guideline Budget on the perspective of the rights of persons with disabilities that the National Planning and Development Agency (BAPPENAS) published is the strategic national development tool to articulate the SDGs and disability rights implementation in Indonesia.
- A strong political commitment from the Indonesian Government is needed to implement the SDGs in line with the CRPD.
- The participation of persons with disabilities and their representative organizations are urgently needed to address disability rights in development and to have equal rights and opportunities.
- The government needs to adapt the 2013 policy curriculum for general education for SLB, especially part B to not discriminate or measure the ability of Deaf students and to provide training for Deaf teachers.
Status of persons with disabilities
Regarding the total number of persons with disabilities in Indonesia, currently there are no reliable numbers since many persons with disabilities are not counted as many do not have a civil ID, have no access to participate in surveys, live remotely, and are excluded from censuses. Consequently, there are varying estimations on the number of persons with disabilities in Indonesia. For example, according to LPEM FEB University of Indonesia Research Center there are 31 million persons with disabilities in Indonesia (2016) or an estimated 12.5% of the total population. On the other hand, findings from the Sosial Ekonomi Nasional (Susenas/National survey bureau/BPS) survey in 2012, indicated that the number of persons with disabilities is 6,008,661.
Indonesia ratified the CRPD in November 2011, but has not signed or ratified the optional protocol. Regulation number 8 from 2016 is the most recent law on persons with disabilities. This regulation is an improvement from the previous one: regulation number 4 from 1997. Nevertheless, the law is not fully consistent, but fairly consistent with the CRPD since the law was passed after Indonesia ratified the CRPD.
The National Statistical Office (BPS) started collecting data on persons with disabilities in 2015. They partnered with UNFPA, WHO, UNICEF, Ministries, government institutions, researchers, and organizations of persons with disabilities to develop a research instrument on disability by adopting the Washington Group Short Set of Questions. The research instrument was launched on May 7, 2014, but there has been no update since.
Indonesia does not have specific poverty-eradication policies inclusive of persons with disabilities. In Indonesia, the social protection systems and measures do not include persons with disabilities. Only the national cash-transfer program managed by the Ministry of Social Welfare is inclusive of persons with disabilities. There is no inclusive social protection at the national level even for health care, education or disability pensions. In the Yogyakarta Province, there is a provincial healthcare program that covers health care and assistive devices for persons with disabilities, but this is not in place in other provinces. In Jakarta, the former Governor Basuki provides local governmental health insurance that covers persons with disabilities. It is important to note that Indonesia is a decentralized country, thus there is local autonomy in which provinces can manage and create policies and programs at the district level as long as national laws and regulations are followed.
Most persons with disabilities do not control their own money due to stigma. In particular, people with psychosocial disabilities, people with intellectual disabilities, and Blind people continue to have difficulty opening bank accounts or receiving bank loans. Consequently, stigma and discrimination are major barriers among persons with disabilities in this area.
Persons with disabilities do not enjoy equal access to health services in Indonesia. Most persons with disabilities in Indonesia are poor and lack access to government health insurance. Only in a few cities and districts can persons with disabilities enjoy access to healthcare services. For example, in Jakarta and Yogyakarta, persons with disabilities have access to healthcare services because the government has political will and commitment to implement inclusive policies for persons with disabilities. While there is access, services are not fully accessible and gaps remain.
The coverage status of essential healthcare services for persons with disabilities in the Yogyakarta Province (not general coverage in Indonesia) is as follows:
- maternal health care – there is “Jampersal,” a local government insurance that covers women with disabilities who give birth;
- infectious diseases;
- non-communicable diseases; and
- therapy and early intervention for children with disabilities.
National health coverage does not have an inclusive and integrated approach for persons with disabilities. The most concerning for Indonesian citizens with disabilities is that in 2019 all local health insurance plans will be nationalized, which means all health coverage at the local level will be integrated in the national health insurance program. And, in fact, the current national health insurance program does not align with CRPD obligations. For example, affordable assistive devices are not yet budgeted in the national health coverage program. It will take a long time for CRPD principles to be implemented into national health coverage in Indonesia.
Women and girls with disabilities
Women and girls with disabilities face many challenges in Indonesia. The patriarchal culture in Indonesia places women and girls with disabilities in more at-risk situations compared to men with disabilities. Moreover, stigma and discrimination cause women and girls with disabilities to encounter many difficulties in accessing education, employment and health care. Consequently, this creates increased rates of poverty among women and girls with disabilities.
Women and girls with disabilities experience a high rate of abuse and violence at approximately 30 percent. Inappropriate health treatment is one of the roots of violence against women and girls with disabilities. Also, many women and girls with disabilities experience violence and abuse carried out by shamans or traditional healers. But, unfortunately, only a few of these cases are reported. Due to the aforementioned, gender and disability is a critical issue in implementing disability-inclusive development in Indonesia.
Although Indonesia has regulations stating that public buildings and facilities must be accessible, persons with disabilities do not have equal access to the physical environment, transportation, information and communications technologies, systems and other public services. Accessibility has not been an important consideration in Indonesia and only a few cities provide accessibility in public spaces. More recently, there has been a movement to push for accessibility in Indonesia, but the implementation is far from ideal. For example, all the buildings in the District Offices of Boyolali are built with ramps, but then some of them are used for parking instead, thus blocking the accessibility features into the buildings.
Togo is an interesting case as it is the only country to have volunteered to review three years in a row (2016, 2017, and forthcoming in 2018). The CBM office in Togo was instrumental in supporting the umbrella DPO – Fédération Togolaise des Associations de Personnes Handicapées (FETAPH) – in Togo to participate in the VNR consultation process. Specifically:
- In 2016, the CBM office in Togo organized a meeting with FETAPH’s program department to raise awareness regarding the SDGs, namely over Goals 4, 8, 10, 11, and 17 in which persons with disabilities are included. Documents were provided to FETAPH even though most of them are in English. This meeting and further exchanges related to this topic contributed to equip DPOs and enhance their participation in the SDG implementation process.
- In 2016, during the first VNR report, FETAPH was not directly involved in the consultation process, instead the participation was through the department of persons with disabilities within the Ministry of Social Affairs. However, the information provided through the VNR questionnaire (facilitated by the International Disability Alliance, CBM, and the Stakeholder Group of Persons with Disabilities) provided a better understanding of the SDG follow-up and review process and the importance for persons with disabilities and their representative organizations to be involved.
- In 2017, FETAPH’s participation increased during the second VNR consultation process. This was partially due to the fact that the second VNR report was linked to the National Development Plan, 2018-2022 which in turn is linked to SDGs. An example of participation is that CBM and FETAPH collaborated to complete a form distributed by the Ministry in charge of the National Development Plan to stakeholders, financial partners, and other civil society members. The purpose of the form was to provide information on initiatives to be implemented during the period of 2018-2022, and the results will feed into the National Development Plan, which is under validation.
As an outcome of advocacy efforts at the national level, the government of Togo referenced persons with disabilities three times in the 2017 VNR. Specifically, the Ministry of Social Action supported 47 persons with disabilities in Lomé with food and granted micro credits to 53 women with disabilities through a partnership between the National Fund for Inclusive Finance and the Ministry of Social Action for “vulnerable” women. In addition, a grant was given that provided 60 tricycles and 60 wheelchairs to 120 persons with disabilities in 2015 by the Ministry of the Environment in partnership with the Ministry of Social Action to increase the resilience of persons with disabilities during natural disasters.
In addition to the references of persons with disabilities in the 2017 VNR, FETAPH, participated in data collection through the VNR questionnaire. FETAPH also participated in a validation workshop which took place in Lomé from 8 to 9 June, 2017. During the meeting, it was discussed that the SDGs have still not been implemented in Togo, and consequently little has been carried out at this point.
FETAPH presented its advocacy requests and inputs, and was prepared for this largely due to the information provided through the VNR questionnaire. Ultimately, it was difficult to get the advocacy requests included in the report due to various reasons. First, the report needed to be as concise as possible, so written recommendations were not included, but only shared orally. Second, the Goals under review in 2017 (SDGs 1, 2, 3, 5, 9, and 17) were not directly related to persons with disabilities.
Even though FETAPH’s inputs were not concretely addressed in the VNR, FETAPH was involved in the elaboration of the National Development Plan. The following needs of persons with disabilities such as employment, education, health, and accessibility are included in the plan. The plan will be validated in the coming months and its implementation will begin in 2018.
Overall, FETAPH recommends to the government of Togo to (1) adopt the national law related to the protection of persons with disabilities and its enforcement decrees, (2) the establishment of inclusive education in Togo, and (3) the inclusion of persons with disabilities into national statistics.
Status of persons with disabilities
Due to the lack of a national survey on persons with disabilities in Togo, data on persons with disabilities is unreliable. The national statistics institute survey from 2015 indicates that persons with disabilities represent 2.2% of the population (enquête QUIBBE 2015: Questionnaire Unifié des Indicateurs de Base et du Bien Etre), but there is no data on how many women or men with disabilities are in Togo. Due to the unreliable data in Togo, FETAPH bases its work on the WHO and World Bank report (2011) that estimates that 15 percent of the global population comprises persons with disabilities.
Togo has Law n° 2004-005 on social protection of persons with disabilities, which was adopted in 2004. The CRPD and its optional protocol were ratified seven years later in 2011.
There are specific policies to eradicate poverty, including the social-protection policy, employment policy, and national health policy. Persons with disabilities, through their representative organizations, are involved in the further development of these policies. The issue lies in the actual inclusion at the implementation stage in which technical efforts and financial commitments are required to improve the quality of life of persons with disabilities. Although, one positive example, is that the national fund for inclusive finance provides micro credit to women with disabilities.
Social-protection systems and measures do cover persons with disabilities in Togo. There is a pilot cash-transfer program in two regions, although there is no data on the number of children with disabilities covered. In addition, eye care and physiotherapy are covered by the national health insurance for persons with disabilities working in the public sector.
In Togo, there are no legal barriers preventing persons with disabilities from being in control of their own financial resources. The problem is that many persons with disabilities, especially in rural areas, do not have financial resources because of the lack of livelihood opportunities for them.
Persons with disabilities can access general healthcare services, which are open to all people, although there is no policy regarding accessibility to healthcare services. The challenges emerge with specific services, such as the lack of accessibility of a childbirth table for some women with disabilities. Also, health and rehabilitation services are not affordable for all persons with disabilities due to poor economic conditions.
There are various barriers for persons with disabilities when trying to access regular healthcare services. These include lack of accessible buildings and written materials, difficult access to reproductive, maternal and child health for persons with disabilities, and the high cost of technical and rehabilitation resources for persons with disabilities (wheelchairs, tricycles, prosthesis, canes, and so forth).
In Togo, there is one national and four regional public centers providing physical rehabilitation support and assistive devices for persons with disabilities. The problem is the poor and unsustainable quality of these materials and that these devices are not affordable since the devices are not subsidized by the government.
Women and girls with disabilities
The main challenges that women and girls with disabilities encounter in Togo include lack of access to healthcare services, including assistive devices (canes, wheelchairs, tricycles, hearing aids, and so forth); lack of access to inclusive education, including professional training; and lack of access to employment (public and private), including financial and resource support.
There are no statistics on if women and girls with disabilities experience high rates of abuse or violence in Togo, but there is a significant number of girls and women with disabilities in “non-comfortable” marital situations, and often, women and girls with disabilities take on more of the responsibility of caring for their children without the assistance of their husbands.
Togo does not have regulations requiring that public buildings and facilities are accessible for persons with disabilities and consequently persons with disabilities do not have equal access because most buildings (especially the old ones) are inaccessible. From advocacy, the government is making efforts and new buildings (primary schools, markets, courts, and so forth) are accessible with ramps. In terms of transportation, not all infrastructure is accessible. For example, transportation by bus is not accessible for wheelchair users, but the new airport in Lomé provides the minimum standards of accessibility. Information and communication technologies are accessible to some persons with disabilities, but not all. For example, on national television, a sign language interpreter provides access to news to deaf and hard of hearing persons. However, this is only during a brief period during the day (at 1 pm) when most people are not home, and private television does not provide sign language interpretation. In order to continue and strengthen the advocacy in this area, FETAPH is fundraising to organize a national survey on accessibility for all persons with disabilities in Togo.
The institute of statistics in Togo is based in the department of planning and development. The institute was in charge of the national census in 2010. The institute published a survey result in 2015 indicating that in Togo 2.2% of the whole population compromises persons with disabilities. The results obtained are not satisfactory because data collection was not carried out in a cooperative way with DPOs. Thus, the data collected on persons with disabilities is far from the national reality. Currently, FETAPH is advocating and raising funds for specific data collection on persons with disabilities in Togo.
In closing, the linking of global processes and national realities is an area of strength for CBM. The two aforementioned examples of Indonesia and Togo in the 2017 VNR process highlight the importance of disseminating information, creating synergies, and raising awareness between global and national processes to truly leave no one behind.