Ninety-five percent of the 2.2 million disabled people in Thailand live outside Bangkok. They experience extreme hardships and discrimination because of the urban-rural divide.

The discrimination they face comes in many forms, including lack of access to ID cards, healthcare, education, employment, transportation, and other basic social activities, according to our interviews with stakeholders in Bangkok, Phayao, and Kanchanaburi. All of these are basic human rights.

Many disabled people in the provinces have become homeless due to a lack of education and job opportunities. Even those with university degrees have difficulties finding suitable jobs in the provinces. And not all of them can secure employment in Bangkok.

Staff supporting disabled people outside Bangkok also face a wide array of limitations, including lack of budget, lack of vehicles, understaffing, and precarious contracts. Their requests for equipment and supplies, support, and improvement are often delayed, denied, or undermined at all levels of government.

Survival challenges

Thitiwut ‘Keng ’ Daorueang (right) and his mother Bang-onsi Munma

Thitiwut ‘Keng’ Daoruang, a youth with intellectual impairment in Phayao, has no access to education because no school in the area can provide the special education he needs. When he was younger, the closest school for disabled children was hundreds of kilometres away from Phayao. Traveling there each time cost as much as 2,000 baht, but Thitiwut received only 800 baht per month from the government.

“In the past, there was this kind of school for disabled people in Chiang Rai and Chiang Mai, but Phayao Province did not have one,” said Bang-onsi Munma, Thitiwut’s mother. “Later on, a centre for disabled people was established here, but he still couldn’t go back to school because the centre accepts only applicants who are not older than 18 years old.”

Bang-onsi is a single mother who, on a lucky day, earns only 200 baht, an amount that supports both herself and her son. If she is not experiencing knee pain, she will fry crickets that she farms at home and sell them nearby. This is her only option since she cannot work away from her child for long periods of time.

Thitiwut is not the only one lacking access to education. Thailand has a law that requires all Thai citizens to receive nine years of compulsory education up to lower-secondary school. However, the Social Innovation Foundation found that 94% of disabled people have received only a primary school education, and only 2% have graduated from university.

Lack of education leads to a lack of jobs and income, which means they cannot take care of themselves. Without guardians or relatives to support them, they eventually become neglected, naked, homeless, and stigmatized by society. Having three meals a day, clothing, and access to healthcare when ill gradually becomes an impossible wish.

Anchalee Siriwongjai, General Disability Service Centre, Parent Association for Individuals with Autism, Phayao Province

Anchalee Siriwongjai, a staff member at the General Disability Service Centre, Parent Association for Individuals with Autism, Phayao Province, said that with the association’s support, autistic children will gradually develop the ability to take care of themselves. Although the process takes time, it is an important step towards fostering greater independence for these children.

“Most of the disabled in Phayao are unemployed. They cannot take care of themselves because they have no income. For example, suppose if one day their guardians are not there, who will take care of them? Some do have relatives, but their relatives do not take care of them. Then what will their living conditions be like?,” said Anchalee.

“And if they are found walking along the road, they are yet again perceived as bad people, despite the fact that they’ve troubled no one. But they are seen walking along the road, so people assume they must be bad, mentally unstable, crazy, something like that. Once their parents are dead, they become a burden on society again. People must come asking for donations so that they can survive, but in reality it is not like that.”

In fact, they have been trying very hard not to burden others. Parinya ‘Cowbell’ Singkaeo, another individual with intellectual impairment, was very diligent in learning about information technology and English from YouTube. He also pursued non-formal education and graduated with a high school certificate.

However, Parinya could not advance further because no universities in the area accept autistic people or applicants with a Type 7 Disability. As a result, he is unemployed and does not have a regular income. His remaining dream is to open a sweet shop selling bubble tea in front of his house, but even that dream seems far-fetched.

Parinya ‘Cowbell’ Singkaeo

Sometimes, disabled individuals decide on their own to leave their families. They choose to become homeless because they do not want to burden their relatives. Wichan Unok, a volunteer for homeless care in Kanchanaburi, told us about one disabled person who slept at the province’s transportation station because he did not want to trouble his family members.

“Currently, there are three homeless disabled individuals in Kanchanaburi province. The ones often talked about are the disabled without limbs. There is one who cannot get about and needs to rely on a wheelchair. The other two move by crawling and survive by begging because they can do nothing else,” said Wichan.

“Homelessness among the disabled is a complicated problem. Most of them survive by asking for donations or begging. Other groups who have enough strength, we will support so that they can have an occupation, can take odd jobs, or can seek employment. But this group is quite unable to keep working.”

Even if they receive occupational training like other homeless individuals, and even if there are non-discrimination measures in place, employers remain less inclined to hire disabled individuals in practice. In the provinces, unemployment is much more severe for disabled individuals due to the lack of a social safety net that exists in the capital.

In Bangkok, there are more job opportunities and support programs. These include the Hire Me Project by the Mirror Foundation, a hiring platform for homeless people focusing on manual work. Fresh Station by the same foundation, sponsored by the Bangkok Metropolitan Administration (BMA), also provides various sanitation services for homeless individuals, including laundry, toilets, and showers.

In the provinces, such support does not exist. Disabled individuals who are homeless may go for months without a shower. Due to their physical limitations, they cannot bathe in lakes or rivers. If they attempt to use a public toilet, they are often chased away. They survive by picking up leftover food. If they fall ill, all they can do is lie down and wait in hope that someone may pass by.

Support Shortage

Wichan Unok, Volunteer for Homeless Care, doing Fieldwork Behind the Kanchanaburi Province’s Bus Terminal

Claiming that they have been trying to provide better support, the government enacted the Persons with Disabilities Empowerment Act in 2007 and amended it in 2013. To implement this law, the government established one-stop service centres across the country to receive applications for Disabled Person ID Cards and provide information and advice on accessing their rights and benefits.

On paper, disabled people may use their ID cards to access numerous forms of assistance. These should include access to an adequate allowance, as well as education and occupation support. But as demonstrated, this has not been the case. And the gap in providing these basic needs poses a survival threat for the disabled especially in rural areas.

Despite the fact that 2.1 million disabled people had the ID cards in 2023, it is not something that can be taken for granted in remote areas. In fact, it is a great challenge for them to get one. In the case of Phayao Province, the one-stop service centre is anything but one-stop. Furthermore, none of the contact points are accessible for disabled persons in remote areas.

“The one-stop service centre for disabled persons is located at Phayao Hospital, but when it comes to issuing the ID card, they still have to go to the provincial hall," said Anchalee.

“Disabled individuals living in remote areas cannot come if they don't have anyone to bring them. If no one can actually bring them, they end up being disabled persons without an ID,” said Anchalee. “When it comes to issuing the ID card, they have to come to the provincial hall. Why don't officials from the provincial hall go out to the remote areas instead?”

Chareeporn Yodfa, the President of the Phayao Provincial Council of Persons with Disabilities of All Types

Chareeporn Yodfa, the President of the Phayao Provincial Council of Persons with Disabilities of All Types, said that many people still do not have the ID card. The first unavoidable obstacle is that doctors might delay confirming a disability if there’s a chance of recovery, especially in the cases where people have had an accident and are unable to walk.

“Initially, they might give them 6 months to wait come back for another examination. Some people become bedridden and cannot come after 6 months. Some don't have relatives to bring them, or they live in a remote area like hill tribes in faraway mountains. Some don't even know whether being disabled comes with rights,” said Chareeporn.

According to Chareeporn. geographic distance and a lack of information are significant barriers, particularly in large provinces like Chiang Mai. In districts such as Galyani Vadhana and Omkoi, many disabled people have yet to apply for their ID cards. “Some people don't have a card, so they don't have rights,” said Chareeporn.

If they want to go to school or the hospital to use their rights, they face the same problem all over again. Anchalee’s General Disability Service Centre vehicles can travel distances of no more than 150 kilometres due to regulations. In one case, Anchalee recalled that a disabled person had to travel as far as 60 kilometres to get a transfer at the centre.

Unlike in Bangkok, which offers various forms of public transportation including the sky trains, the subway, buses, or taxis, other provinces have much fewer bus routes available and rely heavily on personal vehicles. Several decades ago, Chareeporn had to take her young child from Phayao to a hospital in Chiang Mai. The memory of the hardship remains vivid in her mind.

“Back when my child was young and we had to go for medical treatment in Chiang Mai, we had to take the bus. The bus service was quite limited, so we had to book tickets at 8:00 am and wouldn't arrive in Chiang Mai until almost 11:00 am. We had to schedule doctor's appointments for 11:30 am or even 1:00 pm to see the doctor. Then, with the last bus at 4:30 pm, we had to make sure to catch it. Otherwise, we'd have to find a place to stay overnight, which was quite difficult,” said Chareeporn.

“Some children can't sit on a public bus, like if they're scared or can't be around a lot of people. This is a limitation for disabled people. And for people with physical disabilities, it's the same. They have to climb up high stairs, and how can someone in a wheelchair do that? Thailand isn't like other countries that have low-floor buses that people can push themselves into. This is a limitation when it comes to traveling long distances for medical treatment.”

Can the Local Administration Organization help? Chareeporn said yes, but with a big caveat. The Local Administration Organizations do have vehicles to take disabled people to a hospital upon written request. However, this kind of support is provided only on an occasional basis due to a limited pool of resources.

“If they want to go to a different province, they’ll quickly say there’s a problem with traveling outside the area because there aren’t enough vehicles,” said Chareeporn. “They only have two vehicles, and these must be used within specific areas. The driver might ask if there is a daily allowance for traveling outside the area, or they might say it’s inconvenient to send someone to a different province.

The service centre where Chareeporn works does not have its own vehicles. The staff must use their personal vehicles at their own expense out of a willingness to help. They can only claim fuel costs from the fund, with no compensation for the driver’s time or vehicle depreciation. Due to the lack of support, this service is provided solely for the centre’s members and is not available to everyone.

The staff have asked for more help. They are fed up and want to change things for the better for disabled people. However, any attempt at change is futile due to bureaucratic delays. In fact, the bureaucracy is so obstructive that it is difficult for them to even perform the basic functions they currently provide.

"This month, we submitted three projects developing skills for the disabled and rehabilitating families with autistic children, but they didn't make it to the meeting," said Anchalee. "They said, 'It's too late.' The project reviewers told us that it wasn’t sent in on time. 'It'll be included next month.’ But the children can't wait.

“You write one project , and by the time it gets approved, and by the time they finish arguing and by the time they’ve finished fighting among the committee, it’s slow and takes a very long time Sometimes, the workers themselves begin to get fed up, having to struggle with what seems like nonsense,” said Anchalee.

“You write a proposal this month, and you might not see it approved for about another three months. And this is the period when the budget hasn’t arrived yet. There is a youth who needs to see a doctor in Chiang Mai. They come to ask us if we could take them to the doctor because they had an appointment with the doctor. We said if they want, we can take them there, but we must add the word ‘but’ because the budget for 2024 hasn’t come through yet.”

Job Insecurity

The government consistently neglects the rights of disabled individuals in rural areas, failing to address their needs for IDs, education, transportation, and healthcare.  Despite this, some disabled individuals remain determined to fight and even have graduated from the education system. There should still be some hope in the job market. Unfortunately, this is not the case.

Kanchana ‘Pear’ Inta, who has physical disabilities affecting the movement on her left side, is an example of a disabled person struggling to find employment in Phayao. Despite earning a higher vocational diploma with a major in secretarial studies, Kanchana continues to face significant challenges in competing in the labour market.

“Pear is an orphan. Her mother died. So she stayed with her aunt. She’s got a higher vocational diploma, applied for jobs, but still hasn’t received a response,” said Chareeporn.  According to her, Kanchana is also looking for a scholarship to pursue a bachelor’s degree programme where she can study on Saturdays and Sundays.

According to the 2007 Persons with Disabilities Empowerment Act, disabled people who hold a bachelor's degree can more easily become civil servants as they are exempt from taking the Part A Examination organized by the Office of Civil Service Commission. Additionally, some workplaces employ disabled people so that they can be exempt from other legal requirements.

Section 33 of the 2007 Act requires employers or state agencies to employ a set ratio of disabled individuals. If they choose not to, they must contribute to a fund under Section 34, or provide special concessions for the disabled to sell goods or services or become a contractor under Section 35.

According to a speech by Prime Minister Srettha Thavisin last year, around 20,000 businesses and government agencies have inclusive hiring policies. Out of the 860,000 working-age disabled people in Thailand, only 54,000 are currently employed. The Department of Employment, Ministry of Labour, said that in the 2023 fiscal year (October 2022 - September 2023), 15,651 disabled people or their caregivers received benefits under Section 35. But again, these measures rarely reach the provinces despite the fact that around 95 percent of disabled people live outside of the country’s capital.

Chareeporn said that "in Phayao province, it is still relatively very limited because it is a small province. At the national level, there are companies that act according to the law. But in our province, if there’s anything, it is only around the Subdistrict Health Promoting Hospitals, and all of their positions have already been fixed.”

Khwanchira ‘Palm’ Phinitsuwan, a visually impaired person who studied in Chiang Mai, and later trained in massage and worked in Bangkok before returning to her hometown of Phayao during the COVID-19 pandemic

When the provinces are unsuitable for disabled individuals, relocating becomes a necessity for a better life. Khwanchira ‘Palm’ Phinitsuwan, who is visually impaired and received special education from a young age, decided to continue her studies and look for job opportunities in Bangkok because there was no such thing in her hometown.

"Back then, I hadn’t thought there would be any work to do at home. So I decided to work in Bangkok. At least, I wouldn’t be a burden to my mother, and I could also send her money," Khwanchira recounted. "There was a foundation in Bangkok that teaches specialized massage therapy. I trained in massage therapy there for about two years. While making a living there, I also learned to travel with a white cane, carrying on from what I learned in Chiang Mai, and I learned to cook rice and simple dishes that I could make on my own."

While Bangkok offers more job opportunities and a better life, the COVID-19 pandemic forced her to return home. "I decided to return because at that time COVID was spreading, and my mother began to fall really ill,” said Khwanchira “She was serious ill so my family told me to come back to stay with my mother. I stayed to take care of her until she passed away.”

After her mother’s passing, Khwanchira started a small chicken farm at home to make a living. “The income from the chickens is actually not enough, it has more to do with my passion that I do this,” Kwanjira explained. “My personal expenses are around 1,500 baht. There is a small income from the disability allowance. My sister is working in a different province, so she sends me money sometimes.”

For many disabled individuals, the capital city offers significantly better prospects compared to the provincial areas. This has also been the case for Phatharaphon ‘Nam’ Thiangnin, who is visually impaired. She shared her experiences of moving to Bangkok, highlighting the opportunities that have come her way since making the transition.

"In Bangkok, there are numerous job opportunities. I have been working in a call centre for True Corporation for over five years now. I also sell lottery tickets, sometimes I do busking, and I transcribe Thai audio tapes as side jobs. But now, there is more demand for lottery selling, so I no longer accept audio transcription work," said Phatharaphon.

"After graduating in 2014-2015, I still had no job. I sang in different provinces, performing at the Annual Red Cross Fairs and busking. I felt that considering that I already had a degree, I wanted to make use of the knowledge I had studied and find a job. Coincidentally, in 2016, a company called for applications for its call centres."

Before she landed her current position in Bangkok, she had worked with different branches of the company in other provinces including Khon Kean and Phrae. She resigned in mid 2018 before relocating to Bangkok to work in the same position at the end of the same year. “Back then it was an annual contract and I feel that the salary did not match with my qualifications,” said Phatharaphon. 

Phatharaphon ‘Nam’ Thiangnin, a visually impaired person, travelled to Bangkok in search of work, including call centre data operator, transcribing recordings, busking, and even lottery vendor.

Phatharaphon holds a Bachelor's degree in Thai Language with second-class honours from Nakhon Ratchasima Rajabhat University. Although her degree was an advantage, it was much harder for her to find a well-paid job that matched her qualifications in the provinces. She had been rejected many times, but one particular time lingers in her mind.

“I applied to an organization whose name I can no longer recall. They gave the reason that they couldn’t hire a blind person, could they? Because I couldn’t see, it wasn’t convenient when traveling, and so on. They gave their reasons. In the end I was rejected. I wasted a lot of photos and documents on job applications, you know,” said Phatharaphon.

"In terms of services, Bangkok is superior, such as for transactions like opening a bank account or financial dealings, anything like that. In the provinces, they do not quite understand how they have to provide services for us or whether the blind can do this kind of transaction. It seems like they don’t have much information, or they don’t have much experience providing services for the blind.

“For example, at the hospital you need relatives to accompany you. Otherwise, they wouldn’t know how they have to provide a service for us if it comes to signing documents or going into an examination room. But if it is a hospital in Bangkok or a private hospital, they will take care of it right away, taking us to fill out the documents, taking our history, taking us to the examination room to receive the medicine, as well as sending us home.

Structural limitations

As we interviewed people with firsthand experiences, the same theme emerged again and again: the quality of life for 95% of disabled people living in rural areas is much harder than the 5% living in Bangkok, despite the presence of the Ministry of Social Development and Human Security (MSDHS), the provincial social development offices, and the local administrative organizations.

In Chareeporn’s view, instead of providing 2,000 - 3,000 baht in financial aid on a case-by-case basis only “when there is a news report or an issue arises,” the government needs to focus more on long-term solutions. One structural issue is that the Disability Fund remains centralized under the MSDHS, which covers a wide range of responsibilities beyond disability issues.

“Currently, the organizations for disabled people themselves are trying to fight to make the fund a legal entity, but the MSDHS doesn’t let it go,” said Chareeporn. “The government believes that if a state agency oversees the fund, they can control it. But if the private sector oversees a large fund like this on its own, they are afraid that it will have problems. So, things remain as they are.”

Because the MSDHS controls the fund, it has control over the nature of work contracts for local staff. “The people working at the service centres have no job security,” said Chareeporn. “They are fund employees and are not enrolled as civil servants. The only civil servant is the director of the provincial service centre.” Because of this, the staff often opt for jobs with more stability.

“It takes time to understand the work involving the disabled, and it takes time before we start working well together. In a while, they pass the exam and move on somewhere else. There is no continuity.” Chareeporn elaborated about the nature of new staff members who have come and gone during her tenure at the service centre. Additionally, there is the problem of understaffing.

“One of the rights is the right to request a personal assistant (PA) for disabled people. But there aren’t enough PAs to support a large number of disabled people. Suppose that this subdistrict has one PA, They can take care of five disabled people. Even though there are actually hundreds of disabled people, the number is still limited to just five,” said Chareeporn.

In her view, PAs are more essential in rural provinces than in Bangkok. Due to the lack of job opportunities in Phayao, relatives of disabled people often move to Bangkok in search of employment, leaving the disabled behind. The disabled in the provinces are also often poorer and in greater need of help, but, according to Chareeporn, “in some subdistricts, there are no PAs at all.”

Access denied

In the provinces, the disabled not only lack access to government support and employment opportunities, they are also deprived of access to basic social activities. On this matter, Chareeporn provides us with a striking example: the disabled are often excluded from meetings that concern their own lives.

The office of a Subdistrict Administrative Organization (SAO) in Phayao province has a second floor. The SAO has the duty to develop the quality of life for all groups, including people with disabilities. So, they often run projects to educate the disabled about their rights. But people with certain types of disability cannot access the second floor.

Some administrative officials or involved parties often dismiss the need to include disabled people directly, suggesting instead that caretakers should represent them. This approach can lead to the concerns and rights of disabled individuals being overlooked if their caretakers do not actively advocate on their behalf. As a result, some disabled people may remain unaware of their own rights.

When it comes to activities, meetings, or ensuring genuine participation for people with disabilities, it is typically those whose physical conditions allow them to attend who show up. Many are excluded due to a lack of sign language interpreters or Braille materials. There are also issues with participant limits; sometimes, only the disabled individual is invited and not their caretakers due to budget constraints.

“How many disabled people are there who are SAO Presidents ? Disabled people likely have no chance to become leaders. They have to become followers or the disadvantaged. They can’t rise to become leaders. Although there is a vast amount of money in the disability fund, amounting to who knows how many billions, this money still cannot be used effectively to develop the disabled,” said Chareeporn.

This kind of problem is not limited to administrative facilities, but also extends to other basic institutions. “Disabled people often cannot participate in social activities. Homes, temples, schools, do not have accessibility features. How many temples have ramps or Braille? As a result, most types of disabled people do not visit temples because there are no facilities,” Chareeporn explained.

The MSDHS has no official statistics on the ordination of disabled people. Blind monks are very rare, and there is no information about deaf monks. Meanwhile, the Buddhist ordination code includes lists of qualities that either prohibit or deter a person from being ordained as a monk, including various forms of disabilities, having a criminal records, and military desertion.

“If disabled people want to become monks, they won’t get ordained. Just because you want to become a monk doesn’t mean you will be easily ordained," Chareeporn said.