Community Support Services for Children with Disabilities and Their Families

Provided by House of Smiles

PREPARED BY RACHEL M. SMITH
DISABILITY ACTION COUNCIL
MAY 2003

INTRODUCTION

House of Smiles started in August 2000 in order to provide community based care for orphaned/abandoned children with disabilities. Five children, formerly living in a government-operated orphanage, were integrated into the community through contact with children from the neighborhood and one child is now attending the local public school.

After the two-year pilot phase was completed, it was recognized that House of Smiles (HOS) could also provide support to families caring for children with disabilities in the community. On a practical level, transportation for three deaf children in the community to Krousar Thmey has been provided through HOS.

The staff of HOS has received regular weekly training in various disability issues. Since the beginning of HOS only two staff have left. Thus HOS staff are experienced and trained in caring for children with disabilities and in fact have knowledge in a wide range of physical and mental disabilities.

It is difficult to know clearly how children arrived at the Nutrition Center because of the lack of records. However according to statements made by staff of the Nutrition Center, in most cases the families abandoned the children. It is assumed that the families did not know how to care for the children and thus perceived no other option than abandoning the child.

WHAT IS RESPITE CARE?

Respite care for families caring for caring for children with disabilities is one-way HOS could provide community services. In western countries respite care services have been offered for caregivers of elderly parents. Respite care services have also been provided for caregivers of children/adults with disabilities. This usually involves the elderly parent or person with disability staying at a center for one to two weeks thus allowing the caregiver to rest.

In the context of Cambodia, respite care could mean a place for families caring for children with disabilities to leave the children for a morning, afternoon or both. The families would then have time to earn money or tend to other household duties. The children would perhaps receive needed physical therapy and/or participate in educational play activities.

Essentially this model of respite care could be referred to as "daycare". However the main goal of a program like this would be to allow family members the time they need in order to earn much needed income. It has been recognized that disability is both a result and a cause of poverty especially in developing countries. Lack of medical care can lead to disability and then caring for a child with disabilities leads to a family member staying a home instead of earning needed income for the family.

HOS COMMUNITY SUPPORT SERVICES

Who would receive these services?

Families caring for children with multiple disabilities would be invited to access services at the respite center. The target population would be families living in the Toul Kork area in close proximity to HOS. The children should be 6-13 years of age. Children accepted into the program could have a wide range of disabilities including children with a mental disability only. Children with severe behavior problems could not be accepted unless staff was available for one to one care for the child.

Children with mild physical disabilities, rather than attend activities at HOS, should be referred to the local public school or Lavalla School. The Inclusive Education Project of the Disability Action Council could assist in this area. Children who are blind or deaf should be referred to Krousar Thmey. Currently, children with both physical and mental disabilities have no educational/play activities available in the Toul Kork area.

Where would the respite center be located?

The respite center would be located at House of Smiles. HOS currently has games for children and other needed equipment. Three of the children living at HOS would be home in the afternoon and also be able to join activities.

Who would conduct the activities?

As previously mentioned, the current staff of HOS are both trained and experienced in caring for children with disabilities. They are a resource for family members in the areas of physical therapy techniques, educational activities, and locations of other services for children with disability. Family members themselves could also be requested to serve as "volunteers" with the program on perhaps a rotating basis. Benefits could be offered to volunteers such as rice. Additional staff will be required depending on the number of children.

What would be the activities?

The respite center would have two major activities:

Educational/play activities for children with disabilities
Resource center for information about available services for children with disability

Activities could follow those conducted at the Rabbit School and Little Conqueror's program of Servants. The activities would be adapted for the level of functioning of the children. The staff could also teach the children self help skills including dressing, feeding, and toileting. If appropriate, basic physical therapy exercises could also be offered for the children.

A resource library could also be set up with various books concerning disability issues. Phones numbers and addresses of NGO's working with people with disability should also be available if additional services are needed.

PROJECT SCHEDULE

Phase One: (three months)

Conduct a survey of the number of children with disability in the neighborhood surrounding HOS. The National Center for Disabled Person's (NCDP) is working in the Russey Keo district. Cambodia Trust is also working in Phnom Penh. NCDP and Cambodia Trust could also be a source of information of children with disability living in the area. Survey information would include age of the child, type of disability, and a description of the family situation. Families would also be asked if they felt a respite center would be helpful for them.

Phase Two: (one month)

A clear program of activities would be developed. The program activities could start three days a week initially and then increased to five days a week. Family members would also be invited to meet the staff of HOS and decide if their children could attend the program. It should also be made very clear to the families that the support services offered are not residential. Parents could be required to sign an agreement with HOS with the roles and responsibilities of both the parents and HOS clearly stated. The children come for the day and then return home. The program should start with 5-7 children and then increase if appropriate. The maximum number of children with two-three staff would be ten children depending on the level of skill of the children. Activities could also be scheduled involving other children living in the community.

Phase Three:

After six months of the program's operation an informal evaluation of the program should be conducted. Family members and staff should have the opportunity to express their satisfaction/dissatisfaction with the program.

CONCLUSION

HOS has been in the same community since August 2000. Often neighborhood children come to play at the house. Also children from HOS go to other houses to watch television. Now HOS can reach out to the community and help other children with disability. The staffs are trained in various disability issues and are a valuable resource for families caring for children with disability.

The children of HOS would also benefit from meeting other children in the neighborhood. It would further integrate the children from HOS into the community.

As with the Little Conqueror's program, giving support to families who care for children with disabilities benefits both the caregiver and the child. Children with disability can improve skills for daily living and thus allow caregivers more time for household duties. Respite care is one way to assist families caring for children with disability.

Annual Estimated Budget

HOS Community Support Services

ITEM	COST
Staff salary (65 USD x 2 persons)	1,560
Transportation	130
One meal x 10 children	720
Soy milk	240
Activity supplies (books, paper, paints, etc.)	150
Therapy equipment (cushions, specialized chairs)	400
Furniture (stools, tables)	100
Resource materials (books for parents, pictures, photocopy, etc.)	100
TOTAL	3,400 USD

Contact List

Cambodia Trust (CT)
Mr. Hok Ly - Community Base Work Team Leader
Phone: +855-(0)12-812-034
Email:hokly@online.com.kh

Center for Child Mental Health (CCMH)
Dr. Bhoomi Kumar- Director of CCMH
Phone: +855-(0)23-300-534
E-mail: bhoomij@forum.org.kh

National Center for Disabled People (NCDP)
Mr. Klann Mab
Phone: +855-(0)23-210-140
E-mail: ncdp.cbr@online.com.kh

Servants to Asia's Urban Poor (Servants)
Ms. Noun Sophat
Phone: +855-(0)11-951-944
E-mail: cambodia@servantsasia.org