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Report by Atthaphon Sichitsanuwaranon
Photos by Kotcharak Kaewsurach

This feature article will take you to a place in Surin Province to see the quality of life of people with disability outside urban areas and their access to the right to modify their home environment. According to the rights of the disabled, state welfare provides 40,000 baht per home to holders of Disability Cards issued under the 2007 Disability Act. In Rattanaburi and Kap Choeng districts, are they able to access these rights? And what is their quality of life?

When you’re disabled, what can you do to make your house feel like home? Accessing the right to modify the local home environment

Houses or residences are often designed and built for people with normal bodies. But once a resident becomes disabled for any reason, it inevitably becomes impossible for them to live comfortably in the same house from then on. It becomes necessary to fix things so that they can go on living there without the need to depend a lot on someone around them, or even live alone. If the homeowner or resident is well enough off to invest and renovate their house or install facilities, there will be no problem. But the reality of Thai society today is that physically disabled people cannot often access jobs and have no daily income. Without a sufficient income, investing to make their residence more suitable for them is difficult.

This feature series will take you to Surin Province to look at the quality of life of people with disability in Rattanaburi and Kap Choeng districts and their access to the right to modify their environment through the “state welfare” of 40,000 baht per house, according to the rights of the disabled who have Disability Cards issued under the 2007 Persons with Disabilities Empowerment Act. Are they able to access these rights? And what is their quality of life?

An impoverished life

Bunchong Yindi and the family home

The first house is in Rattanaburi, which is around 60 km from Surin city centre. Most of the terrain consists of hills and forests. It took us about 45 minutes to reach Bunchong Yindi’s house.

Boonchong, 50, told us that before his disability his main job was in construction, working on roof structures. He was the breadwinner looking after his family of 5; he has 2 daughters and 1 son. His second daughter has a disability where her brain works slowly. He himself received his disability from a road accident in 2022, resulting in a spinal cord injury. His arms and legs have no strength, but his hands can still hold things and he can still stand by himself. He still has enough strength to move his leg forward but needs to use a wheelchair. He needs medication to defecate , and uses a urinary catheter.

Bunchong Yindi

“My life right now, I can’t do anything at all. My wife had to become the pillar, doing everything. My second daughter helps get rid of my urine. I can’t defecate by myself, there’s no strength. I don’t go to the toilet. The wheelchair can’t get in, we’ve tried, and the wheels got stuck since the floor of the house is soil and sand. When I take a shower, I have to sit in the wheelchair and my wife pushes me to bathe by the side of the house. When I shower I have to use a walker to hold myself up, then move to sit on a plastic chair then get washed. When I get back to bed, my nerves are strained and I shake. I have to rest because I am tired from using a lot of strength.”

Patthama Phaosa-at

Patthama Phaosa-at, his wife, said that right now, she is working as the only breadwinner. She works at a petrol station. Her income each day was 315 baht, and she gets paid every 15 days. If she takes a day off, she will not get paid her daily wage. The truth is, even if she worked hard and worked every day, there would still not be enough money to live on. Where will the money come from for the electricity and water, the diapers, the tissue paper? Her kids still have to go to school. “Normally when I work in the afternoon, if one day I have to change his diaper I would need to ask the workplace to leave, then come back to work.”

“Last year I ran for help at many places, but there was none. I told them I was in trouble, please help me. (Her voice trembles; she cries.) My husband is sick, my mother is also sick. It’s distressing, excuse me. Sometimes it’s very frustrating and I don’t know what to do. I run into the woods to scream and get it out of my system,” Patthama reflected on her very difficult life.

Around Bunchong’s sleeping area

This family cannot access the state’s services, either central or local. They went to try asking at the local offices but got nothing, since their house has no land deed. “There is a house number here. We moved here 3 years ago. They said we could live here but there was no title deed. It’s on royal land and overlaps with the forest. If you look at it, it’s overlapping, so we can live and farm here but can’t sell it,” Bunchong said.

They wanted to have some funds to improve their house enough for Bunchong to live more independently. “Then I could go to the toilet and wouldn’t need to use diapers all the time. If I could go by myself, and wheel myself there, it’d be convenient for me. My wife wouldn’t have to trouble herself as much, and I can help myself. I would feel better, not having to trouble her, so she can do other things. She has to be responsible for everything. If I can get a good floor, better than this, it would help my wife out a lot. Right now, for my food, my wife needs to get everything for me. When I want to eat, she has to feed me,” Bunchong said, “If we can make it a permanent place to live here, if we can make it so we can stay, I want them to give us a budget to do the house. Lay bricks on the floor. Being a citizen who wants access to my rights gives me the heart to fight. I don’t want them to abandon us.”

In front of Thanachit Saiho’s family home

Another case is Thanachit Saiho’s family. The reason for his disability is a drowning incident, which caused damage to a part of his brain which controls his body. He is unable to help himself or communicate. He has to be under the care of Sairung Saiho, his father, and Kanokkon Sonloet, his mother, who also has a sight defect. In a family of 4, there are 2 with disabilities. They receive support in the form of disability allowances totalling 1,600 baht per month. This family wants to build a space in front of their house so their son go to sit outside to relax from time to time, while the mother wants a flush toilet since the squat type is inconvenient – she cannot wash the toilet by herself since she cannot see.

Kanokkon Sonloet and Sairung Saiho

Kanokkon said, “Right now the situation is worse than before since my legs are broken and I have to sit in a wheelchair and it’s even more difficult. Plus, I also have to go for kidney dialysis.” More than that, they do not know at all what rights they have which can help them. Sairung said that he was the only one working, taking jobs in the neighbourhood at 350 baht per day. If there is a job a bit distant, he would not be able to take it since there would be no one to look after his disabled family members. “I don’t know what steps there are to get my rights, I don’t know anything. I don’t have a phone, I don’t have anything to look it up. Most of the time I only see information from the TV. I don’t really watch about this news.”

Although Thanachit’s family found out later that according to rights for people with disabilities they can request funds to improve their environment, they also cannot access this right due to the same obstacle as in Bunchong’s case: they have no land deed.

Difficulty in accessing rights

Thotsawat Chinkaeo, Community Development Officer

Thotsawat Chinkaeo, a Community Development Specialist who has worked in the Phai Subdistrict Administrative Organisation area, Rattanaburi District, for 7 years, explained that even if people with disabilities know their rights and have rights, it is not that easy to enjoy them. “There are no small number of steps. Once a person makes a request, it would take at least 3 months. It also depends on the estimate and design, and how much work the construction team has. Even if all the other documents are ready, if there is no design and estimate, it can’t go forward. The quickest would be 2 months.”

“But the problem isn’t only with the local authorities, you also have to look at provincial level officials from the Social Development and Human Security (SDHS) office. When will they make a visit? Sometimes it takes a long time, according to their regulations. The quickest is about a week, the longest takes months. It may be a long time for the disabled.”

Thotsawat told us about the steps needed which sound tiresome and taxing. “It begins with the person with a disability having to tell their requirements to the community leader. He then goes to survey, then sends the information to the Community Development Officer. Then the Community Development Officers do the survey by themselves again, collect documents, photos and personal data, then send the case to the provincial SDHS office. A provincial SDHS official checks the site before approving. When all the information is lined up, they will give the approval then assign a construction team from the Subdistrict Administrative Organisation (SAO) to design, sketch, and estimate the cost according to what the disabled person needs and see what can be done within the 40,000 baht budget provided. The list can itemize construction labour costs, but the budget for materials will be reduced as some will need to go to labour costs. Then everything will then be sent back to the provincial SDHS office for approval. The funds will be transferred to the SAO. The local officials then take the funds, order the materials and looks for a construction team to start the work.”

As regards the budget, there seems to be a way out. Thotsawat explained that when there is not enough budget to meet the needs of people with disabilities in the locality, which receives, on average, 2 households per year, the community needs to make a decision together. “The community makes a survey and makes a priority list. The village head and members of the SAO and the Village Health Volunteers discuss who is in the most difficult situation then prioritises who should go first. This becomes the community’s criterion, where the community together decides that the budget of 40,000 baht is too little. At least, it should be equal to the provincial budget for physical rehabilitation of the Provincial Administrative Organization, which is 70,000 baht – it could cover labour costs as well.”

What would a life which can access rights be like?

In another area, in Takhian Subdistrict, Kap Choeng District, within the Huai Thab Than - Huai Samran Wildlife Sanctuary around 64 kilometres away from the city and also bordering Cambodia.

Noi and Sombat being interviewed at their home

Here there is success: Noi and Sombat Charat, a married couple, both aged 64. Noi registered as a person with disability 4 years ago, with locomotor disability due to illness and old age, with symptoms of pain from the waist down to the legs. When she walks, she gets dizzy and numb. Sombat, her husband, has pain in his knees, and he has had brain surgery. When he crouches, there will be pain and he is not be able to stand up, similar to Noi. The two live alone together.

Their house was modified in 2020 using the budget granted by an SDHS budget of around 40,000 baht. They waited about 3-4 months for the money. The 40,000-baht budget was not enough to cover the labour costs. The village head asked other village members to help construct their house which was finished in 10 days. Their downstairs was modified from what existed previously. The ground floor has now been changed to bricks and cement with a separate bedroom , but upstairs still has the same materials as before.

Noi and Sombat Charat

Their life is different from what it was. Now they do not go upstairs. Neither of them can manage it. They do not have to struggle to get upstairs. They sleep downstairs. Now they do not have to crawl upstairs and can sleep in the room downstairs instead. Whenever they came downstairs, they were afraid of falling because of their bad legs. They would feel very numb and painful. Living downstairs, they feel better. Today, the quality of life has improved for both because they were able to access their rights.

Can decentralisation help?

Although people with all types of disability can request this right, limited local budgets require criteria for the community to select who receives the budget first. But MSDHS regulations state that the person making the request must have the status of extreme poverty to receive this right first. But because of different limitations, disabled people’s houses in each area may each require different kinds of modification, and some face obstacles regarding land deeds which prevent them from accessing this right. With limited budgets each year, local authorities face an obstacle that they try to solve by accepting donations, and look for other ways to be able to complete the modifications.

Prayun Soichit, Deputy Chief Executive, Takhian SAO; Phichai Phoeisiri, Chief Executive, Takhian SAO and Chiraphak Chindasi, Community Development Officer, Takhian SAO

Chiraphak Chindasi, a Community Development Officer, said that the current 40,000 baht budget may not be provided correctly in line with estimates. Labour is a major problem, resulting in house modifications not being completed according to schedule. Sometimes they use volunteers for the construction, who may be from the village committees or community leaders. Some have other work commitments and would not be able to work full time, meaning there would be no regular construction worker on the job, so the responsibility eventually falls on the leader. In addition, materials have become more expensive, and some houses needed extra donations from the community.

Prayun Soichit, Deputy Chief Executive of the Takhian SAO, said that there are a great number of disabled people recognized as poor in the area, and there is the problem that the disabled have no legal documents of their own at all. It becomes a matter that goes against the regulations and criteria that have been specified. This problem needs to be solved/addressed first. There should be an exception over legal documents just enough so that we can help them. “When the disabled lack papers, they lack opportunities to receive benefits. So they have to keep on suffering. We can only help them day by day, so they can carry on their lives in terms of food and living expenses,” Prayun said.

Phichai Phoeisiri, Chief Executive of the Kathian SAO, said that if there is decentralisation and more authority is given to the local authorities to approve funding, it would reduce the steps in the approval process, which would be good for the people and directly meet their needs. The criteria for budget prioritisation should be done through the community but still follow the MSDHS regulations which states that a person making the request with the status of being poor should receive the right first. This would increase operational flexibility.

“For me, decentralisation both of the authority and duty to make decisions and of the budget, allows local government to better solve local problems. 25% or 35% of the budget is currently with local government. It would be good to share 50/50. As for modifying the environment, if there is still a problem about local land, there should be an Act to solve the complex legal issues. If we can do it ourselves, it would allow our disabled brothers and sisters to access their rights,” Phichai said.

“If the is more authority locally, some people may see it as turning people with local power into a mafia. But in reality, it’s not like that. We would be able to take close care of the people and have a budget to help manage help in many ways. Like me, I’m here for no more than 2 terms. No more than 2 consecutive terms. There is already a regulation enforcing this, so it can’t be like that anyway. Also, if you don’t administer well, in the end the people won’t choose you again,” Phichai Phoeisiri said.

Fighting through a myriad of regulations and problems to access disability rights

To enable people with disability to live in their homes comfortably in their circumstances is not an easy thing at all, since the Thai government system contains many regulations which become obstacles preventing them from getting their rights. Those working in these circles must fight, strategize, adjust their approach and coordinate help from many parties.

In terms of national-level policy, Varawut Silpa-archa, Minister of Social Development and Human Security, gave an interview to the media on 20 October 2023, saying that the government was trying to find budget to increase the amount for modifying the homes of persons with disability to 100,000 baht per household so that it will be enough, as well as find 2,000 baht per month more in funds for disabled people to spend on necessary expenses at, in addition to payment for disability equipment.

In practice, Phongsi Hiranborirak, Director of the Surin Provincial Disability Services Centre, said that in 2022 the Centre received a total budget of 2,300,000 baht . The next year it was increased to 3,600,000 baht, but it was still insufficient since in Surin, there were many people with disability who wanted to modify their homes in 2023. They received a list of 90 names in total, which exceeds the annual budget that they got.

Phongsi Hiranborirak

The 40,000 baht budget per household is most likely not enough due to increased costs of material and labour. Phongsi said that to build a safe, suitable and convenient home for independent living, the budget would need to be increased to at least 70,000 baht and no more than 100,000 baht per house.

Other than the budget, another problem was found that people with disability who want to apply for the right to modify their homes have no land rights where their buildings are located. Phongsi said that this issue may be able to be worked around if the owner of the land gives consent.

“If the person with disability does not hold the deed themselves, but their family or relatives do and wish to modify the home, the Ministry’s solution is to have the owner give what is called written consent to renovate the building. There’s a consent form for the deed owner to give their consent so the disabled person can get the right to modify the house they’re living in,” Phongsi said.

However, if the land overlaps with public land, it would be quite difficult to solve. The Centre advises getting the consent of the local Subdistrict Administrative Organisation on a case-by-case basis. Sometimes, if the rights are in dispute, it will be difficult. First, they would need to find out which agency’s land is involved. A legal consultation with the group’s legal officer would be required, and then the feasibility would be discussed with the central authority.

In providing services to people with disability, there is not enough personnel. There is a personnel structure, but it is not suitable to the job. “I would like to have a bigger set of officials. We have currently 9 officials. For the fund there are 2 development officials, 1 social welfare worker, 3 legal officials, 1 policy and planning analyst, 1 accounting and finance specialist and 1 driver. The director is a government official under the Office of the Permanent Secretary who is helping out. We have 9-10 people working but we look after more than 60,000 people with disabilities in 17 districts – that’s a lot,” Phongsi said.

The construction workers’ understanding and attitude is also an important matter. “We once had a problem of when the draftsman made a design they thought of ordinary people,” the Director said and added “We ran a project for construction workers to understand, be concerned about and pay attention to the disabled. We trained local workers starting from their attitude so that they will know how people with disability have to live, how they feel. We had them simulate being disabled in every way. We had workers try out being physically disabled, deaf and blind. They reflected that they felt very frustrated, and that they understood people with disabilities better and after the training it helped solve the problem where their designs did not meet the requirements of people with disability,” Phongsi said.

Building a house according to the resident’s wishes

Asst Prof Katanyu Hawsutisima, Faculty of Architecture, Urban Design and Creative Arts, Mahasarakham University

Asst Prof Katanyu Hawsutisima, Faculty of Architecture, Urban Design and Creative Arts, Mahasarakham University, the Head of the Universal Design Centre who is involved in creating learning to understand local adaptation of the home environment for people with disability, explained about designs which do not meet requirements and lack participation. This impacts how the disabled live and may increase obstacles rather than improve convenience and safety. Asking people with disability about their needs and simulating disability creates a collective experience, which helps with effective designs since the designer understands, and the user can enjoy access by turning the obstacles in the design and execution of the modification process into suggestions from their experience.

“A lecture doesn’t make anything happen. They get knowledge but there’s no change. Transformative Learning is learning to create change in oneself. To expect change in oneself, there needs to be something which moves you. In normal training, they sit and listen then go to work and forget it in a moment. But simulation engraves it on their hearts. It’s what I believe and see. It has to go through the heart, the mind, and actual practice,” Katanyu said.

“Don’t make disabled people feel like they’re not the owners of their homes. When you look at the condition of their home and make an estimate, you should have a discussion and come to a conclusion with the homeowner that very day. Look at what their daily life is like, what do they do and where. Tell them what you’re going to do to their lives and ask for suggestions on what they like or don’t like, what they want or don’t want, since that’s their home.”

Utilising volunteer workers to solve the problem of insufficient funds may cause new problems if viewed in terms of the permanence of temporary volunteers, says Katanyu, because he does not trust volunteers. Volunteering depends on the person. If they want to volunteer now, come and help. If they do not want to, then we cannot say anything. It would be better to consider a reasonable remuneration for the worker. The worker who works on this should have the heart for it, should have ties to the community and want to look after the people in the community. There should be remuneration. Maybe not a lot, with labour costs set at 30% of the cost of materials.

Naphasin Khonken, construction contractor

Naphasin Khonken, a construction contractor, spoke in a similar way. He said that before they start work, they should first ask the person with disability about how they sit. Is the toilet too low or too high? They must have them take a look. Is it easy for them to get out of their seat? The modifications must be in line with their condition. “An important principle constructors need to go by is that it’s their home so they should follow the wishes of the homeowner. It is also important to work calmly, changing things according to their needs so people with disability can help themselves. It would help lessen the burden on other family members. Their parents would be less tired, their life would be happy,” Naphasin said.

Civil society participation

Chalermchai Thongsook, co-founder of the Foundation for Community Soul

Chalermchai Thongsook, co-founder of the Foundation for Community Soul, confirms that if people with disability could access the right to modify their homes, it would mean the lives of the disabled and their families becoming better. From his experience working with children and people with disability in Surin for more than 10 years, he found that the home environment affects the lives of the disabled in many dimensions. The state sector must support increasing the budget and remodelling the management methods, since Thai society has started to become an ageing society, which may increase the proportion of people with disability. He suggests to the state sector:

“An outsider should be hired on a concession from the Department of Empowerment of Persons with Disabilities specifically for residence modification. Suppose the Department wants to modify the homes of 50 disabled people in Surin. They should find an agency with expertise in this to do it. I believe that it would speed up the process and quality control would still be the same, since there is much more flexibility for solving problems for the people. The state is the main funding source,” Chalermchai said.

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