JOINING FORCES: Claire and Bertrand’s story
“A family mission that has deeply changed the way we relate to those in need.”
Mental disability: The hidden reality
“We want him to speak, but we do not know how to help him.”
Piset’s parents are deeply worried about their fouryearold son, whose gentle, childlike face and typical features of Down syndrome reveal his condition. They travelled more than three hours from Siem Reap to meet psychologists and doctors, hoping at last to understand the developmental delays that have been so clear for years. Despite taking him regularly to medical centres for vaccinations and checkups, they have never received a proper explanation of his condition, as these visits focused only on medical procedures, never on his development. In Cambodia, obtaining a clear and accurate diagnosis of intellectual disability is not easy. The Centre for Child and Adolescent Mental Health (CCAMH) marks a significant step forward in a country with little experience in supporting these patients. Each month, the mostly Cambodian team travels from Phnom Penh to Battambang to provide medical and psychological support to families in the north. That morning, about twenty children, together with a few teenagers and young adults, sit in the bishop’s garden, waiting their turn. Over the next two days, the team will meet around a hundred families, including Piset’s parents.
Dr Dearozet, a psychologist, listens carefully to their story and observes Piset’s development. She explains in simple terms what Down syndrome is, hands them brochures, and shows a few easy exercises they can try at home. She arranges regular followups, with the next appointment in two months. Most importantly, she reassures them: their son can go to school, and when he turns five, they will plan the next steps together. “Does he like dancing? Then dance with him! Encourage him to play with other children,” she says. Piset’s case is far from unique. Many families are left helpless by the lack of information and suitable resources. In most rural areas, doctors do not have the training to diagnose or support children with intellectual disabilities.
EDUCATION AND HEALTHCARE: A TOUGH BATTLE
Educating children with intellectual disabilities in Cambodia remains a huge challenge. The government has rolled out inclusive education policies, but real progress is slow. There are few accessible facilities, and teachers rarely have the specialised training they need. With few suitable teaching resources, these pupils are often left on the sidelines, or even pushed out of mainstream schools. According to the charity Karuna, set up in 2016 by Bishop Enrique Figaredo to support the education, inclusion and welfare of vulnerable people in Cambodia, only 3 per cent of the children with intellectual disabilities it supports are currently attending public schools. In rural areas, the challenges are even greater. Schools are often a long way off, role models are scarce, and transport can be difficult
Many parents, unaware of their rights, hesitate to send their children to school, worried they will not be welcomed or might be mocked. To reach people in these isolated communities, Karuna’s teams now take their awareness campaigns directly into the countryside. Several “koyones” (motorised tillers) pull trailers carrying pupils, educators and Karuna team members, who take turns at the microphone to share their experiences and highlight the rights of people with “that special something.” Occasionally, local officials join the convoy. The government passed a law in 2009 to protect and promote the rights of people with disabilities, guaranteeing access to education, healthcare and social protection, yet on the ground there is still a wide gap between the law and its implementation. The Disability Action Council (DAC), made up of members from 15 ministries, government bodies, charities, international organisations and representatives of people with disabilities, is supposed to lead the implementation of the National Strategic Plan on Disability. In reality, progress is slow, held back by a lack of resources, limited specialised training, and poor coordination between the different groups involved.
In response to the lack of support, local initiatives are stepping up. Kampuchea Sëla Handicap (KSH), for example, offers vocational training tailored to young adults with intellectual disabilities, giving them the chance to learn new skills and gain more independence. Valentin Dubé, the charity’s deputy director and a French national who has been actively involved since 2014, explains: “Until recently, these young adults had very few options. They either stayed at home, often cut off from the outside world, or were sent to state-run boarding houses, if any were available, or to day-care facilities, where they were fed and looked after, but given little real stimulation. (…) Today, we support twenty-seven young people through several stages. They start by living in boarding houses, where they learn social skills and daily routines. Next comes an introduction to work in the jam-making workshop, focusing on following rules and being punctual, followed by experience in a café-restaurant to prepare them for employment. Later, a programme with partner businesses, including cafés, restaurants and hotels, allows them to earn a higher wage while receiving ongoing educational and family support.
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The independence programme marks the final step. Here, young people are supported in signing their first work contracts and finding somewhere to live. Shared flats are available for those who need them, and there is also help to set up small businesses or to join a family trade. The oldest person we support is now thirty-seven. There is no set time limit; everyone moves forward at their own pace. To tackle the shortage of skilled staff, the charity has also built its own internal training scheme. Training for social workers on intellectual disability is still very limited, and awareness remains low, even within government,” says Valentin Dubé. In response, KSH runs a six-month course for its staff, covering beneficiaries’ specific needs, teaching methods and monitoring tools. The organisation also works with partner groups to share its approach and to help educators address adolescence and adulthood more effectively. The team is led by a Cambodian director who has been in post for ten years and has adapted practices to local culture, making the programme both practical and sustainable.
Outside the main cities, speech and occupational therapy are virtually absent. Countless children grow up without the support they need. No specialised training exists in Cambodia, holding back the growth of these vital professions. Some charities fly in foreign therapists to train local staff, but these efforts are rare and have only a limited effect.
FROM POVERTY TO SOCIAL EXCLUSION
Intellectual disability is not just a medical or educational challenge. It often brings severe economic hardship. UNICEF reports that the costs linked to disability can double a household’s poverty rate. One parent often has to stop working to care for the child, cutting the family’s income. In rural areas, the lack of suitable services leaves some children at home with no support, increasing their isolation. Supporting families is therefore crucial. “Many parents simply do not know where to turn for help.” Colleagues Chheat and Chhean, executive director and project manager for people with intellectual disabilities at Karuna, emphasise the urgency. “We need to step up awareness campaigns and build a more structured support network,” they say.
They go on: “The problem is made worse by poor awareness of people’s rights and the financial support available. As a result, only families with a steady income can access suitable services, leaving others behind.” Some charities try to meet these challenges, offering free or low-cost assessments, tailored education and social support to families. They work with government departments to extend the reach of existing services, though better coordination is still urgently needed. In the Battambang countryside, Champhirhom, a young boy with autism sponsored by Children of the Mekong, illustrates this reality. His mother says: “When I am not watching my son, he wanders off or helps himself to the neighbours’ cooking pots, and I have to repay them, even though I do not always have enough to feed my own family.”
The Happy Life School, a specialised school for around sixty children with intellectual disabilities or autism, is due to open in a few months on a large campus that will eventually host 500 pupils from nursery to secondary school. For Champhirhom’s mother, the news brings a glimmer of hope. Her son will be able to attend in the mornings, giving her the chance to work, feel less isolated and support her family
GOVERNMENT APPROACH: BALANCING AMBITIONS AND HURDLES
“The Cambodian government has introduced practical measures to guarantee the inclusion of all citizens, including those living with an intellectual disability,” note Chhean and Chheat, who head the charity Karuna.
This commitment led to the 2009 Law on the Protection and Promotion of the Rights of Persons with disabilities, which set clear aims: to prevent discrimination, to safeguard rights, and to support physical, mental, and professional rehabilitation. The Disability Action Council (DAC) has since prepared the new roadmap for the National Strategic Plan on Disability 2024–2028. The Strategic Plan for Education 2024–2028 and the National Policy on Early Childhood Development (2010) both underline inclusive education. But in practice, this is harder to achieve. A teacher in an inclusive class explained: “I received no training to support children with disabilities, except from the NGO that recruited me. For now, it is the NGO that pays my salary. I hope that one day, like some colleagues in other schools, I will be paid by the government.”
BUILDING THE FUTURE
Change is underway, despite the challenges. Dr Bhoomi, psychiatrist and founder of CCAMH, envisions a more inclusive Cambodia. Over the past 28 years, he has witnessed the rise of specialised schools and government-backed initiatives. Yet he remains realistic about the obstacles: “Social hardship often worsens intellectual disabilities. We need many more vocational training centres.” He believes that 60 to 70 per cent of people with intellectual disabilities could hold regular jobs if society were ready. He adds gently, “The next generation can achieve great things.” Signs of progress are clear. Events like International Down Syndrome Day, backed by Children of the Mekong, are raising awareness and strengthening parent networks. Disability training could soon be mandatory for teachers, and the combined efforts of NGOs, families, and authorities are making a difference. Attitudes are changing, infrastructure is improving, and children like Piset can look forward to a brighter future. Inclusion for people with intellectual disabilities is no longer a distant dream; it is happening!
“We need many more vocational training centres.”
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Mental disability: The hidden reality
In Cambodia, intellectual disability is finally emerging from the shadows. Long hidden by stigma and family taboos, it is starting to gain recognition. Driven […]
