Article by Kotcharak Kaewsurach
Cover picture by Kittiya On-in
“It is said that people with disabilities are the last to be thought of compared to what happens. Ask if it is like that in the various plans that are drawn up. Disabled people are like any other people; the plans focus on the reactive and being helped. That help did not recognize their needs.”
In 2011, Thailand faced the most severe flood in its history. Information from the National Hydroinformatics and Climate Data Centre, Hydro-Informatics Institute (Public Organization) thaiwater.net, set the damages from the flood: a total of 65 provinces were affected with 657 deaths, 3 missing, 4,039,459 households and 13,425,869 people affected, 2,329 houses destroyed, 96,833 houses partly damaged, and 11.20 million rai of agricultural land and 13,961 roads damaged.
Although there are no figures to indicate how many people out of the entire population faced flooding that year, it is still enough to know that disabled people at that time faced difficulties to a greater or lesser degree, including aid and evacuation which were not comprehensive, and improper care. Disabled people had difficulty in adapting to deal with the situation.
Even though up to today there have been no other floods as big as the one in 2011, Climate Central’s report on BBC news points out that climate change has caused a rise in sea levels with the risk of coastal floods. It is predicted that more than 12 million Thai people will be affected from the increase in sea levels. Bangkok is at risk of being flooded by 2050. This includes disabled people.
We went into the field and talked to people with disabilities, rescuers, and researchers about their concerns and hopes, projecting the problems in the 2011 flood into the future, and whether there any methods or mechanisms. Because there have been a number floods throughout the past year, such as in the north in August and the south in December, it is necessary to be ready for a new wave of floods.
Pathum Thani: Flash flood area where disabled people could not adapt in time
“In 2011, the flood kept rising to the point that we couldn’t stay and we had to escape. At that time, 5-6 people were needed to carry me onto a truck, both me and my wheelchair and my things. After that I had to go to stay in Ratchaburi with my older sister.”
Wanlop Sali is currently the Director of Pathum Thani Centre for Independent Living. In the year of the flood, he was one of the people that had to escape the flood to a safe place. Wanlop pointed to the level of water that entered his house. Although it was not too high for normal people, it was not a good thing at all for a severely disabled person like him.
Although he didn’t have to stay in the middle of masses of water for months, Wanlop is able to narrate the problems he faced as a severely disabled person. He said that in general, some groups of severely disabled people cannot urinate by themselves and need to use a urine bag which needs to be changed every 10-15 days. A consequence from the flood is infection.
Evacuation centres lacked facilities
There were many other people with disabilities who were not able to leave the area due to many different problems, including worry about their home, poverty, having no relatives or anywhere else to stay . The Centre Director pointed out that most disabled people in the area need to stay in shelters which were mostly temple buildings raised above the water levels. Of course, that was followed by the problem of a lack of facilities for disabled people.
“The reason for turning the temple into an evacuation centre was because the temple buildings are raised high, such as the sala kan prian (sermon hall). But if they could choose, disabled people would not like to stay there because there aren’t any facilities. Disabled women especially have to change their sanitary pads and pampers, but there aren’t any separate rooms or a private area. Many would think that it’s inappropriate and the disabled people feel ashamed. They had to take off their clothes and excrete in public or in places with a lot of people like the shelter; it was distressing.”
After the Centre recognised the importance of temples as evacuation areas, they tried to provide information on facilities for disabled people. But the temples did not seem to understand, so it did not achieve much, and so they built facilities near a small meditation centre nearby. They also accepted donations to build a bathroom for disabled people who visit the place, and if something happens in the future, it will be of use.
“There should be a place that a state agency is responsible for. They should organise a place that disabled people can use. There should be an agency which is directly responsible during disaster situations. Where are disabled people, and how are they living? How will we notify disabled people so that they can relocate during floods?
“Another issue is that understanding how to help persons with disabilities is something important. There was a case where someone helped a disabled person but did not also take his wheelchair. A non-disabled person probably didn’t think how important a wheelchair is to a disabled person. I want you to try to think that when you go out of the house you’ll think of shoes. Disabled people are like that as well. A wheelchair is a disabled’s most important part. It’s like our feet that takes us places. Let’s say we don’t take our wheelchair with us and we are taken to a shelter; that disabled person won’t be able to go anywhere, and will just sit there and be a burden.”
From the 2011 incident, the Pathum Thani Centre for Independent Living understood and recognized that preparation is important. They arranged training on giving support to disabled people during disasters. The project ran from 2012 to 2014, focusing on training young people in schools in districts in Pathum Thani on helping, supporting, moving, or dealing with the disabled, such as helping them up and down slopes, moving up and down stairs, taking them to the toilet, getting them into and out of bed, and on and off a boat.
Wanlop told us that he focused on young people because they learn easily and understand flexibility. Teaching them will enable them to know how to help disabled people in the future. If something happens, these young people will be able to correctly help disabled people. Unfortunately, the project did not continue since the province, which was responsible for allocating the budget, saw it as redundant since the province later also organised a similar event. However, the Centre Director affirmed that both the administrative format and target groups of the two projects were different and there was still a lack of participation in management.
Agencies in the state sector saw that recently there has been increased interest, but there is not yet a plan to manage and help with anything. As a person working for disabled people in the area that has yet to see it, he hoped that at least there would be an evacuation centre that could support disabled people in the district or subdistrict for easy access.
Ayutthaya: repeated floods but lacking long-term assistance
As in Pathum Thani, the lack of preparation and information is still something disabled people face, especially during floods. Aree Thongthiengtham, President of the Ayutthaya Association of the Disabled talked about the problems she faced in 2011. The shelter for persons with disabilities did not understand disabled people as well as they should, there were problems with the bathroom and access to the building, there was no slope, and it lacked facilities. Disabled people who were stuck at home did not receive help. She had to take at least 6 people through the floods to the east since they could not stay there. As a member of the provincial Association of the Disabled, she volunteered to be a representative in coordinating the work and saw the problems that existed.
“Some disabled people had to sleep on the second floor and weren’t able to change their urinary catheters. They weren’t able to go out anywhere. They had to stay at home. A province which floods often like Ayutthaya never has any proper preparation or preventive measures despite being a repeated flood and water catchment area. There should already be systematic management. In the 2011 incident, we had to take 6-7 disabled to the Redemptorist Centre, because if they stayed here, there was nothing ready to support them.”
There should be an evacuation centre that is disability-friendly
Ayutthaya gets flooded often. Apart from 2011, Ayutthaya has been flooded all the time. For example, in 2017 there were floods in Bang Ban and Sena districts, but there was too little preparation. Aree said that she has yet to see any long-term support mechanisms where local people with disabilities can voice their opinions or participate. An evacuation centre for the disabled has never been created, either location or personnel.
The question is why these things have never been thought about. Ayutthaya has around 20,000 people with disabilities, Phachi district has around 600 people – why is it not done? In the past, we see that equipment and locations were not at all prepared for disabled people. For people with the money, relatives can take them to a safe place. But people without the money or power have to stay in these places. As the state holds the resources, she thinks that this is it the responsibility of the relevant governmental agencies to start pushing for a solution.
Other than her concern for the future, she is also worried about the work of officials in the area because floods or crises in the past have shown that the Provincial Social Development and Human Security Office still needs to perform the main functions in terms of people and issues. The number of workers is small and there are many problems. The people with more roles are local working groups, and the subdistrict and district administrative organisations, rather than the central agencies for disabilities, especially in her district.
“After the big floods, there was some talk in related agencies on how things should be done. There were various seminars. The province arranged to have a flood prevention plan, learning lessons from the problems that had occurred, and tried to find solutions. They should have information and details that will help them work easier when there is a problem. It was a plan where they went into the field to observe at what points there were disabled or vulnerable groups that needed special care. Disabled people should have some kind of symbol. The subdistrict administrative organisation where I am also does this, but I’m not sure about other places.”
Rescue and helping people with disabilities in floods
One of the important agencies for rescue during floods is part of this. Samroeng Phonrat and Khanakon Buaket, officials at the Office of Disaster Prevention and Mitigation, Bangkok, told us about their work in 2011 and the scope of their duties which became lessons for their work and developed into a framework for future assistance, including preparation, approaches to assistance and prevention, from the experience of disaster to evacuation.
Samroeng Phonrat, head of the Bang Khun Thian Fire and Rescue Station, in 2011 was an Experienced Level officer at the Bang Khae Fire Station, responsible for Bang Khae, Nong Khaem and Phasi Charoen. He said that rescue workers’ main responsibility was to help disaster victims who were stuck in their houses, especially the elderly and children, as well as bedridden disabled people who could not get out themselves. They had to move them to a safe place for an agency or relative to pick up from there.
Khanakorn Buaket, Experienced Level Disaster Prevention and Mitigation officer, talked of the work approach based on core principles for rescue agencies. There are many, from essential operational planning, to safety awareness, establishing an understanding the types of disability and the different kind of assistance that each requires, and the limitations of the disabled. These will be analysed jointly while providing assistance. For example, warnings needed to be sensitive to certain disabilities, such as deafness. Symbols, lights or messages need to be used instead of sounds. For blind people, warning signs or images may be inappropriate. A system of sounds and vibrations should be installed. In general, warnings of emergencies must use more than one channel and use concise, easy to understand language.
Additionally, an understanding of disability is still necessary, since it impacts the methods of assistance in accessing and dealing with, for example, the blind, deaf, and wheelchair users, in terms of readiness with equipment, safe relocation methods and respect for human dignity. Khanakorn said that these were the rough principles in rescue work, but all of this requires preparation and regular training.
Increase in bedridden patients
Samroeng told us that although there been no recent flood as severe as in 2011, there are still cases involving bedridden patients and they are increasing. The reason is because Thailand is an aging society. There was an attempt to identify vulnerable groups for easier management in emergency situations. Boundaries were planned in a communal process with flags or symbols used to tell which house or group needs special assistance. It is a way of prioritising work. Having contact information for relatives helps make work easier.
Samroeng said that once, there was the case of a bedridden patient who died from smoke coming from a nearby fire, because no one knew that there was a bedridden patient lying there. So it is very important to have specific information for officials to understand which points they must be aware of, not just the scene of the incident, and to be able to help in time.
Disaster management plan for persons with disabilities revealed
The Disaster Management Plan for People with Disabilities, 1st Edition, 2017-2021, shows the development of a plan for the disabled in disasters. This plan was created by the Strategy and Planning Division, Department of Empowerment of Persons with Disabilities (DEPD), Ministry of Social Development and Human Security (MSDHS), with the vision “persons with disabilities and their caretakers are safe in disasters” and 3 strategies which are:
1. Develop measures, reduce risks and prepare for disabled people and their caretakers in disasters. For example, evaluate the situation, make a community disability plan, make a preparation manual for dealing with disasters, develop warning systems for volunteers/persons with disabilities, prepare evacuation shelters and centres. The responsible agency is the Department of Empowerment of Persons with Disabilities, MSDHS.
2. Develop a disaster management system and efficiently integrate operations in disasters. For example, integrate collaboration between agencies and networks in disaster management, set up warning systems, identify communication channels, create evacuation shelters and centres and a safe area management system. The responsible agencies are DEPD, MSDHS and disability organisations.
3. Increase efficiency in the rehabilitation and treatment of disabled people and take care of disabled people in a comprehensive and fair manner in all respects, such as developing manuals on rehabilitation and care, survey data on problems, adjust the environment post-flood, and promote access to benefits and treatment. The responsible agencies are DEPD, MSDHS and various disability organisations.
Universal Design should not be overlooked
Sawang Srisom is Project and Planning Manager of Transportation For All and member of the “Disability and Disaster: Empowering People and Building Resilience to Risk” research team. This has allowed him to see more of the problems of the power and adaptability of disabled people in disaster situations.
Lack of preparation was something Sawang could see. He assessed that the policy of providing assistance is still reactive and lacks recognition of the needs of the disabled. The disability management plan for floods is still short on details, especially with regard to Universal Design. He said that helping people with disabilities should not be seen as welfare.
“In the end, Universal Design is essential. We’re not worried about having to go to an evacuation centre. When something happens, we can understand that. It’s just that basic needs should be accessible, and we should be able to use it with human dignity. As for the various methods of help, officials or volunteers should have to undergo training. It’s not just assistance, but assistance in the correct way. Disabled people should be asked about their needs, don’t think for them, or take over. This is the reaction of the disabled.
“Actually, international conventions or laws on persons with disabilities like the Convention on the Rights of Persons with Disabilities (CRPD) or the Incheon Strategy also talk sketchily about the principles. But the important thing is the domestic plan which still lacks coverage. It doesn’t look at the needs of each individual or respect the privacy rights of a person with disability. In the plan it says to help the disabled first. Facilitation and needs should also be included in the plan. While there is nothing happening, it should be improved to be user-friendly and efficient. Because when something happens, it will be okay.”
Sometimes possible, sometimes impossible – structural issues
An organisational structural issue is one thing that has caused problems for working with persons with disabilities. This was reflected in problems during the flood which showed us why some sectors were able to work well with support plans, but why was it that some parts were still lacking. There had been no attention paid or there were no plans, and if there were, they lacked participation. This lack of information integration between organisations meant that working with persons with disabilities and disasters was overlooked. There was no host or main agency responsible for this work.
“I think that the issue of the organisations of the disabled themselves is important. It may be a structural problem of disability organisations in our country as well the fact that they’re separated into types, not issues. Like the association for the blind has to take care of education, has to take care of disasters, has to take care of travel, etc. One organisation has to take care of many issues. In the end they choose just some issues. It may be something people are very interested in or something funders are more interested in. If funders are not interested in disasters, there would be no push for it. Some issues may be seen as something distant. Separating work according to disability types is also difficult. This may be a disadvantage.
“A finding from research says that some agencies are not attentive to this issue, and we can’t really blame them. Disability organisations have limitations with a lack of resources. When there are not many personnel – 1 person looks after 10 issues – it decreases work efficiency. Pushing forward various issues then becomes worse or does not progress. Maybe there should be a talk on how disability organisations in Thailand should work, especially in this situation where one organisation takes care of various issues and there is always overlap. Like education, which is being done by every disability association, but none of the organisations do it together.
“For this, the Department of Public Disaster Prevention and Mitigation and the Department of Empowerment of Persons with Disabilities should work together. I understand that in the past there was no host who could get these 2 organisations to meet, and both organisations have the status of departments. An interesting point is that, for persons with disabilities, there is not much on the issue in the DPDPM. While in the DEPD, there are few who are interested in disasters. What should we do in order to have the 2 organisations meet and bring the knowledge of the two organisations together, which seem to be working separately today?”
This report was made with support from Internews' Earth Journalism Network.