Development Ratings

The Cambodia Trust was founded in 1989. The Prime Minister of Cambodia had called for assistance to help the country’s thousands of landmine victims. From 1970 in Cambodia, civil war, US bombing, the brutal rule of the Khmer Rouge, 10 years of Vietnamese occupation, and independence only finally reached in 1991 all left many people disabled by the conflict. Under the Khmer Rouge (which killed over 1.5m people, or around 20% of the population), doctors and skilled people were targeted as elitist, destroying the country’s medical capacity. 2-3 people a day are still reported as killed or injured by landmines or unexploded ordnance from the wars.

Similarly, tensions in Sri Lanka between the Sinhalese majority and the Tamil minority erupted into civil war in 1983. Over two decades of fighting left tens of thousands dead and many more disabled. Ceasefires have been fragile and short-lived. In 1975, newly independent Timor L’este was invaded by Indonesia. An unsuccessful two decade campaign of pacification resulted in up to 250,000 deaths. An internationally brokered independence in 1999 lead to scorched earth retribution and the destruction of the country’s infrastructure. Decades of fighting left many people disabled. Timor L’este also has one of the highest rates of new leprosy infection in the world: over 17 people in 10,000 vs. the LDC average of less than 1 in 10,000 (source: WHO).

Despite the emphasis on disability caused by conflict in these particular countries, illness and disease, congenital defects, and accidents are major contributors to disablement. Estimates of the numbers of disabled people in developing countries are just that - many disabled people simply do not survive. This is due to poor nutrition, injuries, neglect, birth complications, and poverty-related diseases. James Wolfensohn, the former President of the World Bank, has said “Unless disabled people are brought into the development mainstream, it will be impossible to cut poverty in half by 2015”. Disabled people need higher incomes than the non-disabled to maintain the same standard of living. Often they will have lower incomes (and suffer from debt). This is due to lack of education and opportunities, poor equipment, treatment and facilities, discrimination, and traditional and cultural taboos. Poverty is both a cause and a consequence of disability.

A prosthesis is an artificial limb. An orthosis is a device like a brace to support gait and other musculoskeletal abnormalities. The devices need to be replaced every one to two years, or every 6 months for growing children.

Motivation Trust (see Development Ratings Report) provides wheelchairs and capacity training in Cambodia, Sri Lanka, and Timor L’este. In 2007, a joint wheelchair service was started in Timor L’este by the two Trusts.