Embed Size (px)
Citation preview
HUMAN RIGHTS OF PEOPLE WITH DISABILITY IN PANAMA
Japan International Cooperation Agency (JICA) Costa Rica office
National Secretariat for the Social Integration of Persons with Disabilities (SENADIS)
March, 2006
INDEX 1. General Facts about the Country...........................................................2 2. Philosophical framework .................................................................... 10
2.1 Principles of disability ................................................................... 11 3. Conceptual framework....................................................................... 13 4. Legal Frame..................................................................................... 16
4.1 National Legal Framework ............................................................. 16 4.2 International Legal Framework....................................................... 19
5. Administration and organization of the subject of disability ..................... 24 5.1 Non government, public and private organizations. ........................... 26 5.2 International Cooperation Actions in Disability.................................. 29
6. Profile of Persons with Disabilities in Panama ........................................ 31 7. Public Policies about Disability in Panama............................................. 35
7.1 Indicators ................................................................................... 36 7.1.1 Access to physical space ......................................................... 36 7.1.2 Complaints before the Ombudsman .......................................... 37 7.1.3 Housing ................................................................................ 37 7.1.4 Education.............................................................................. 38 7.1.5 International Classification of Function, Health and Disability (CIF) 39 7.1.6 Community Based Rehabilitation: ............................................. 40 7.1.7 Health .................................................................................. 40 7.1.8 Work .................................................................................... 41
8. Human Rights of the persons with disabilities ....................................... 42 8.1 The situation of enjoyment and exercise of human rights among persons with disabilities ................................................................................. 42 8.2 Principal obstacles that impede the enjoyment and exercise of the human rights of persons with disabilities............................................... 45
9. Conclusions and recommendations:..................................................... 48 10. Bibliography................................................................................... 51 11. Anexo ........................................................................................... 53 1. General Facts about the Country The Republic of Panama is situated in the slimmest part of the American Continent. The country has a territorial extension of 75,517 KM2 with 16,777KM2 in the metropolitan area and 58,739.5KM2 in the rest of the country. The population is a little over 3 million. The climate is tropical, without great fluctuations in temperature and with a rainy season that goes from May to December.
The Central American Andes prolonged into Panama to the highest point in the country that is an inactive volcano of 3,475 meters in height. The geographical advantage of Panama is related to the thinness of its territory, bathed on the North by the Caribbean Sea and in the South by the Pacific Ocean. This position has made it the commercial centre between North and South and between East and West, since its discovery by Rodrigo de Bastidas in 1501.
According to the last Census of 2000, the population of Panama is 2,839,177 inhabitants; 1,406,611 are female and 1,432,566 are male. The population growth rate is 1.7% per year.
Politically the country is divided in nine provinces, three indigenous reservations at the provincial level and two reservations at the borough level. The government system is democratic, unitary, republican and representative.
The government is formed by three Organs: the Executive formed by the President and his Ministers, the Legislative formed by 72 deputies representing the electoral circuits and the Judicial formed by the 9 Magistrates of the Supreme Court.
The municipal government is formed by the Major and the boroughs representatives. Panama has 75 districts and 621 boroughs. Following the modern tendencies, some of the centralized national functions are being delegated to the local governments.
The official language is Spanish, but the indigenous maintain their mother tongue and recently, impulse is being given to bilingual education, giving incentives to the natives to become teachers, doctors, nurses among other professions that may improve the living conditions of the most isolated rural regions as well as respecting the costumes of the different ethnic groups of the country. In the Law of Equalization of Opportunities of Persons with Disabilities (Articles 24, 26, 41, 48) the sign language is recognized as a valid method of communication and requires utilization of interpreters in cases of qualifying exams for employment, arrest for illicit actions and in the case of televised communications. The Republic of Panama is a mix of races that live together in peace. The most significant ethnic groups are Hispanic and natives or descendent of the Spanish Conquerors and of the first habitants of the Isthmus; the afro descendents that came to Panama as slaves by the colonialists; the afro Antillean descendents that came for the Canal construction; the native Indians that constitute 10.1% of the population, other groups are Chinese, Arabs, Jews, Spanish and Italians. Panama is mainly a country of services. Since its foundation it has been obligated route and the most convenient passage for transportation from North to South America and to Asia and Europe. From the 70’s decade, it became the most important banking centre of the region. The Panama Canal since its reversion to Panamanian hands on December 31, 1999, has become one of the most important income generators for the country’s economy. The administration of the ports and tourism are also important sources of income. There are some industries such as bananas, fishing, coffee, sugar and vegetable oil that compete in the global market.
Panama has a Free Trading Agreement with El Salvador and Taiwan and partial agreements with the rest of Central America, Colombia and the Dominican Republic and presently is negotiating treaties with the United States and Singapore. Panama presents marked inequities in the distribution of wealth. According to PNUD studies of 1997 the wealthiest 20% received 63% of the national income, while the poorest 20% only received 1.5%. 37% of the population lives in poverty, and 60% of them are below the poverty line, 90% of the native Indians are extremely poor. 45% of the public expense and 20% of the brute internal revenue is allotted to social programs.
INDICATORS OF THE INEQUITY IN CONSUMPTION COEFICIENT GINI: YEAR 2003 = 0.46
Quintiles* Percentage of
total consumption
Average annual
consumption per person
B/.
Percentage over Q5
Reasons
Quintil 1 (Q1) 4.1 370 8.1 Q2/Q1 = 2.2 Quintil 2 (Q2) 9.0 808 17.7 Q3/Q2 = 1.5 Quintil 3 (Q3) 14.0 1,249 27.3 Q4/Q3 = 1.6 Quintil 4 (Q4) 21.8 1,951 42.7 Q5/Q4 = 2.3 Quintil 5 (Q5) 51.1 4,569 100.0 Q5/Q1 =
12.5 Total 100.0 1,790 39.2
*Each quintil corresponds to 20% of the population from less to more according to annual income per capita. Source: ENV 2003. Ministry of Economy and Finances. Direction of Social Policies.
The studies by the Ministry of Finances and Economy estimate that to eradicate total poverty in Panama, it is necessary to transfer $448 millions annually or the 3.7% of the Internal Brute Product for this population to consume the value of the general poverty line. On the other hand, for people on extreme poverty to become poor not extreme poor, the minimal redistribution should be about $104 millions annually, with which they could consume the amount of the minimal food basket.
According to PNUD, Panama along with Costa Rica appear to have the highest income per capita in the region, but also the highest inequity in the region, because the distance between the average income of the poor and of the extremely rich is more significant than the distance of income between the rich and the extremely rich. Contrary to this observation, in the rest of Central America with the exception of Costa Rica, the analysis of inequity in Panama
indicates that the high degree of inequity is due to the extremely poor groups and not to the extremely rich groups as is typical in the region. The country faces two big demographic challenges due to aging of the population and reproduction of poverty, linked to the difference in fertility rate according to level and income. Pregnancies of poor women duplicate those of the no poor and women in extreme poverty triplicate them. In 1999 life expectancy at birth was 74.3 years, but in the province of Darien, area of little development and primarily of native Indians, this number was as low as 65.1 years.
In 2000, 8% of the population was over 60 years of age, but for 2050 it is projected that 24.4% will be older than 60 years of age. This number is similar to Uruguay and higher than the average in Argentina, Chile and in the rest of Latin American. The increase of life expectancy brings about disabilities in an aging population, decreases the access to care, and increases the number of poor because only 50% of persons at retirement age will receive a pension check. In the cities only half of the population is covered by some kind of pension plan and in the rural areas this problem increases because only 20% of the population is covered. Pension checks are insufficient and decrease the acquisition power of the elderly when their need of medical care, support and technical services increase due to aging. Article 13 of the Law of Equalization of Opportunities establishes that the State will subsidize those that because of the nature of their disability are not able to perform remunerative tasks. This article is not known by the interested parties and the authorities do not comply for lack of funds. The relation between disability and poverty tends to increase with the above mentioned factors. The elderly and the persons with disabilities have no access to the production market and therefore, in the majority of cases, they do not make enough income to cover their basic needs; they require special support from society to decrease functional disadvantages related to disability. They depend in a system of economy that deepens the inequities through the ignorance of the real situation for this particular group.
INCIDENCE OF POVERTY IN PANAMÁ
NO TOTAL
ÁREA CONCEPT POOR POOR PAIS
TOTAL
EXTREMA NO
EXTREMA
TOTAL INCIDENCE
(%) PERSONS
(thousands)
37.2
1,139.3
16.7
511.8
20.5
627.5
62.8
1,924.2
100.0
3,063.5 URBAN
INCIDENCE
(%) PERSONS
(thousands)
20.6
383.3
4.6
85..3
16.0
298.0
79.4
1,477.1
100.0
1,860.4
RURAL NO INDIGENOUS
INCIDENCE (%)
PERSONS (thousands)
54.
524.6
22.3
215.7
31.9
308.9
45.8
443.6
100.0
968.2
RURAL
INDIGENOUS
INCIDENCE (%)
PERSONS (thousands)
98.5
231.4
89.7
210.8
8.8
20.6
1.5
3.5
100.0
234.9
Fuente: ENV 2003. Ministerio de Economía y Finanzas. Direction de
Social Policies
The whole country counts with schools. Education is free and obligatory up to the 9th grade. The literacy index is 91.7%. The education of children with disability has been under the Instituto de Habilitacion Especial (IPHE), institution created in the 50’s to segregate the attention of this population. At the present time, it has special rooms in most provinces and according to their statistics they attend to about 8,000 students with a budget of 13 million dollars. It is important to note that IPHE takes care of the population with disabilities up to age 18, has services for the rehabilitation of children and young adults with mental, sensory, motor and intellectual disabilities. They offer vocational training and have special rooms in some grammar schools. In the rural areas, especially in multigrade schools there is integration of students with disabilities in the regular system and in some private schools students with disabilities are accepted if their parents provide the needed supports. The programs of IPHE are not validated by the Ministry of Education and the students have problems to insert in the regular system. Regarding health care, the Ministry of Health and the Social Security share responsibilities in the health care of the Panamanian population. The Social Security System covers all the workers that contribute with a percentage of their income, their spouses and children. The Ministry covers the rest of the population and is mandated by the Constitution to watch over for the quality of health of the inhabitants of Panama and dictate policies related to health care. The health indexes of Panama are good, with a good coverage of vaccination and pre natal attention that yield to a decrease in maternal and infantile mortality. There is potable water in all boroughs, but access to this vital fluid
and the disposal of served waters is inefficient in the rural areas and in 20% of the urban areas.
10% of the pregnant women have no pre natal control and 10% of the deliveries are given without institutional control.
Malnutrition and alimentary problems cause mental, sensory, intellectual and motor deficiencies. In a survey about life levels of the National Comptrollers Office in 1997, 16% of all children presented some form of malnutrition. In the urban areas, 7% and in the rural 24.4% and among the natives 50.5% of the children presented problems related or derived from nourishment. The highest prevalence is of chronic malnutrition, or small height for the chronological age, which affects 1 out of every 20 no poor children, 1 out of every 4 poor children, 1 of every 3 in extreme poverty and 1 of every 2 native Indian children. Anaemia affects 40% of school age children, 35% of pregnant women and 40% of fertile women.
Early pregnancy, uncontrolled deliveries, malnutrition and anaemia contribute to mental, motor, sensory and intellectual disabilities. The degrees of affectation may vary from mild to moderate and to severe. Mild disabilities may pass unnoticed, because they are not obvious, and those who present mild disabilities are subject to mockery, ill treatment by peers and superiors or go unattended and are discriminated. These are perhaps the great majority of disabilities and to them the environment and society are more hostile.
COUNTRY GENERAL FACT SHEET Official Name: República de Panama
Capital: Panama City Name of the Citizens: Panamanian
Language: Spanish (Official), English (Commercial)
Currency: Balboa. The US Dollar circulates freely and is
the legal currency. Type of State: Republic
Political Division: Nine provinces y four indigenous reservations.
National Day: 03 November Area: 75,517 kms2.
Official Time: GMT-5 HOURS. Limits: North: Caribbean Sea
South: Pacific Ocean East: Colombia
West: Costa Rica. Localization: Situated at the southern extreme of
the Central American Isthmus, at the south east of Colombia and at the
west of Costa Rica. Population: 3,116,277 million inhabitants.
-Male 1,572,280 -Female 1,543,427
Structure according to age. -From 0 a 14 years 964,951 -From15 a 64 years 1,973,514 -More than 65 years 177,812
Growth Rate: 1.7 % annual Disability 52,197, 1.8% of the population *
-Visual 7,891 RURAL 3,493 Urban 4,488 -Auditory 7,981 RURAL 3,531 Urban 4,143 -Physical 11592 RURAL 4,585 Urban 4,216
- Cerebral Palsy 3,804 RURAL 1,292 Urban 2,512 -Intellectual / Learning 10185 RURAL 4,216 Urban 5,969
Ethnic Groups: 75% Hispanic origin,
10% Indigenous 15% Other ethnic minorities,
including Hindis, Jews, European, afro-Antillean, & Chinese.
Political Structure
Constitutional President: Excelentísimo Señor Martín Torrijos Espino, since 1 September 2004,
until 31 August 2009. Government: Presidential Policy State Organs: Executive, Legislative & Judicial
Executive: The head of the State is the President elected every five years through
direct vote. Legislative: The National Assembly is elected
every five years through direct vote. Judicial: The main authority is the Supreme
Court of Justice.
MACROECONOMIC INDICATORS Brute Internal Product: U$ 10,100 Million
Percent Growth PIB 3.0% PIB per capita: U$ 3,516(e) dollars Goods Exports: U$ 771.5 Million
Services Exports: U$ 4,977.3 Billion Goods Imports: U$ 3.3 Million
Commercial Flow Zona Libre de U$ 9,577.3 Million
Colón: Reexportations vía/ Zona Libre de
Colón: U$ 4,432.3 Million
Inflation: 1.4%
AVAILABLE STRUCTURES (2000) Social Security
-Pop. Protected by S.S. 1,850,044 -New Inscriptions. : 43,814
Sum and Quantity de subsidy by Workman’s Compensation.
-Sum U$ 6,165,020 -Quantity 16,756
Healthcare
-Health facilities in 2000 816 -Hospitals 60
-Sub-centres and primary care 220 -Health Personnel -Includes medical doctors, dentists, nurses, aides, X Ray technicians, laboratory techs.
536
Educational Structure
Budget destined to education U$ 508,982,000 Literacy 97.3% Illiteracy 2.7 %
Credits to higher education 1,418 -At national level 1,116
-At International level 302 Scholarships granted 18,649
-At national level 18,450 -At international level 199
Technical Formation at 2000 19,134
Enrollment at national level Primary 383,891
Secondary 231,852 University 109,424
Graduates at national level
Primary 50,523 Secondary 52,466
Source: Contraloría General de la República.
* 1.8% of the population presenting disabilities is an obvious under report which is quite far from the estimates of WHO. It is possibly due to the fact that interviewers report the most apparent or severe disabilities. Most countries that base the reports on the national census will show the same characteristics of under reporting. 2. Philosophical framework
The Panamanian history related to the care of persons with disabilities is not much different to the models of attention utilized in other countries through the times. In other words superstition and divine punishment, over protection, assistance and welfare, biological o medical model and the equation of opportunities, have marked the tendencies in the attention to this population. First of all, due to inexplicable signs, just as the rest of the world, in Panama there was a rejection, hiding and avoidance of family members that showed any type of disability. In a very naïve way they ignore and made invisible the things that they could not understand: “perhaps if I don’t see it, it doesn’t exist”. The birth of a child with a deficiency or the appearance of a disability due to sickness or accident was considered a form of divine justice. People with disabilities were considered a burden to the family and the community. Still to the present day, there are communities that think that it is a shame and a punishment to have a relative with disability. In this model, people that presented disabilities had no access to education, minimal opportunities to health care and rehabilitation and no access to community living. Remains of this model can still be seen in marginal urban areas and among indigenous population. Welfare appeared in the form of asylums and hospitals of life internment for the mentally ill, intellectually retarded, motor disabilities and abandoned elderly. These centres were not conditioned in human resources or structurally to attend the number of patients that required services. To this date, in asylums for the elderly, patients remained confined to their rooms or to their beds for lack of the basic knowledge in nursing and in therapies to decrease their dependence and prevent the increase of disability. In the decade of the 50s, with this model special education, vocational centres and segregated hospitals and institutions for the care of persons with disabilities were created. The bio medical model centres the attention of persons with disabilities in the medical diagnosis, in other words, treats persons from the organic point of view, conditioning the progress to the subjective evaluation of the health care personnel. Decisions are made for the “well being” of the person, keeping the person with disability out of the decision making process, with no input in the treatment plan, denying access to the etiology, prognosis and attention plan of the particular condition. In this model, the segregated specialized attention grows further, framed in a medical diagnosis, centred in the pathology and based in a subjective prognosis. There is more awareness of human rights and society starts to become more sensitive regarding disability issues. In the 60’s
the first organized rehabilitation services start functioning at the Social Security Hospital and Santo Tomas Hospital.
There are significant changes in the issue of disability since the Decade of the Disabled in the 80’s. These changes impact the different regions and countries in a diversity of ways. The Standard Rules on the Equalization of Opportunities for People with Disabilities (UN 1993) contribute to focus the subject in human rights and obligate the States to allow the full enjoyment of such rights. Persons with disabilities have grouped based on common interests and their voice is heard in society. In the 90’s the social changes in favour of the enjoyment of rights of persons with special needs becomes stronger and international organizations, such as the Organization of American States discuss the lines to eradicate discriminatory behaviour based on disability. This brought about the approval, on June 7 1999 in Guatemala, of the InterAmerican Convention for eliminating all forms of Discrimination against Persons with Disabilities. This Convention has been ratified by most American countries, constituting an obligating compromise to all signers. Presently, a proposal presented by Mexico, is being discussed before the United Nations in order to make official the compromise of member countries as to the subject of disability from a human rights perspective. This contribution by the United Nations will enhance the actions of individual countries to correct and improve quality of life. Even though we face a new form of attending disability, even though we have taken giant steps if compared to previous models, we must admit the persistence of such models in society. The most pressing task is to modify the collective behaviour of society in order to begin paying the enormous social debt that society has with persons with disabilities. It is impossible to continue talking about equality, because equality is not the answer to solve inequities. It is necessary to focus on equalization, taking into consideration that is society who has to eliminate the disadvantages in order to offer to the population with disabilities a real opportunity to enjoy their rights.
2.1 Principles of disability
Through the actions of and for persons with disabilities and their families and of the different government entities that attend to the subject, their quality of life and their level of participation in community life have shown improvement. Panama adopts a model based on human rights, promotes universal accessibility, commands respect to diversity, procures the equalization of opportunities, autonomy, independent life and citizen participation, and initiates a frontal battle against poverty, hoping for better quality of life and inclusion in all aspects of humanity.
The following principles and ideas frame all programs of the country, directed to create a more sensitive society toward the population that presents disabilities:
• Human Rights: are part of being human therefore the State must recognize, respect and defend them just as is mandated by the Constitution. These rights are based on the recognition of the dignity of the human being, without considering age, race, gender, social condition or disability.
• Accessibility: refers to the elimination of all barriers or obstacles that impede the full participation of persons with disabilities in social activities. Society, as a whole, must adequate itself in order to eliminate architectural and attitudinal barriers which constitute the worst discriminatory action against persons with disabilities and the elderly.
• Respect of diversity: recognizes that all living beings are different and each has its own peculiarities that make it unique. If applied to human beings it becomes an element that enriches society. It is based on tolerance and acceptance of differences and it is the most solid base for democracy.
• No violence: it is referred to prevent, eradicate and penalize violence against persons with disability, without consideration as to where it comes from and who practices it. It is understood that violence is an act of discrimination that enforces prejudice against persons with disabilities. These actions do not referred only to the physical aspect but also to the institutional actions that deny the opportunity of participation based on disability. In the Equalization of Opportunities Law, Article 51 states that a number 11 is added to Article 67 of the Penal Code. Article 67: Are aggravating common circumstances, when they are not foreseen as constitutive elements or as specifically aggravating of a determinable punishable act the following:
(11) To commit an act against a person with disabilities when the disability implies a condition of vulnerability.
• No discrimination: establishes clearly in the first article of the OAS Convention for the Elimination of all forms of Discrimination against Persons with Disabilities, that discrimination is every form or distinction, exclusion or restriction based on disability, previous disability, consequence of previous disability or perception of present or previous disability with the purpose of impeding the recognition or enjoyment of fundamental freedom and human rights. The preference or distinction directed to support social integration or positive discrimination is a tool of equalization because it favours the objective of personal development. Law 42 of Equalization of Opportunities establishes criteria for preference of care in health centres and hospitals and in employment.
• Equalization of opportunities: promotes changes in society in general, in order to allow full enjoyment of rights to the persons with disabilities. In other words, promotes universal access of all to housing, social security, education, health, community life, culture,
transportation, communication, sports and any other activity enjoyed by human beings.
• Autonomy and independent living: refers to self realization of individual’s life project to which all humans are entitled. In the case of persons with disabilities it is necessary to attend promptly and integrally their bio - psychosocial needs in order to insure their goals, decrease dependence and procure a greater autonomy and participation in social activities.
• Citizen’s participation: recognizes the right of persons with disabilities to play a protagonist role in all social processes to insure that their needs are included in the planning and execution of government policies, plans and programs. It is also to exercise the right to participate and to let their voice be heard in the political processes of their community and of their country, though becoming members of committees and community groups, of the political party of their choice and of exercising their vote.
• Combat against poverty: for the most part, persons with disabilities have little or no access to quality education and employment justly paid; therefore they are among the poorest in the social tissue. The situation of poverty or extreme poverty deepens their disability. The poor present a higher risk of disability due to the state of deprivation of essential elements in which they live. To eliminate poverty there is a national program that has the objective of preventing disabilities that result from malnutrition, severe anaemia and avoidable diseases.
• Inclusion: society as a whole must make the reforms needed for the recognition of the right to partake in equal conditions of social wealth. It is then necessary that society becomes more sensitive toward diversity and to make of solidarity a meaningful word and a way of life in which those that have more will share with those that have less, but who at the end carry the heaviest burden in production. In Panama the word inclusion has been used mostly in its educational content until recently, where a more holistic approach has been given, in which inclusion means to open doors in all aspects of society for all groups.
• Quality of life: is related to total wellness of a person based on the fulfilment of their needs. The more the needs are fulfilled the better the quality of life, therefore it doesn’t only refer to satisfying the basic necessities. In order to improve the quality of life of persons with disabilities their inclusion in the decision making processes of society can not be postponed.
3. Conceptual framework The Equalization of Opportunities for Persons with Disabilities Law of Panama dates from 1999. This norm defines and establishes the attention to the population that presents disabilities. The definition of disability, as well as the rest of the terms in which this legislation is based to enhance the promotion of the objectives of access and full integration, granting the respect of the rights
of persons with disabilities, procuring maximum self development and participation, will be presented in this section.
The following terms are defined in Article 3: Wellness: state reached and enjoyed by a person when all his/hers need are fulfilled in a manner compatible with human dignity. Disability: functional alteration, permanent or temporary, total or partial, of a physical, mental or sensory nature that limits the capacity to perform an activity in the way or form that is considered normal for a human being. Discrimination: exclusion or restriction based on a disability, as well as the omission to provide the adaptation of the environment that preclude or nullify the recognition, enjoyment or exercise of the rights of persons with disabilities in equal conditions. Equity: principle that conceives the distribution of wealth according to individual needs, possibilities or capacity of the persons object of the distribution and that permits equilibrium in spite of inequalities, limitations or differences. Equalization of opportunities: process through which the general system of society, including the environment, the intellectual media, housing, transportation, social and sanitary services, opportunities for education, work, information, communication, cultural and social life, sports and recreational installations and all the rest, are made accessible to all. Vulnerability: is the state of exposure or high probability to be exposed to different degrees of risk, combined with a reduced capacity to self protection or defence against such risks and their negative results. In 2001, the World Health Organization revised the concepts of deficiency, disability and handicap to recognize that the environment and the function play a very important role in conceptualizing disability. The new concept of the International Classification of Function (CIF) includes deficit, limitation in activities and restrictions in participation, be it due to a health condition, environmental factors or personal factors that alter the performance in function at the organic, individual or social levels. When there is significant loss or deviation of function in a part of the body, a deficiency is present. It can be temporary or permanent, progressive, regressive or static, intermittent or continuous, severe or mild. This deficiency is related to a state of health, but doesn’t necessarily make of the person that presents it a sick person. When the individual capabilities to perform an activity are limited it is considered a limitation at the individual level. When a person with a deficiency has difficulty to perform activities in an environment with barriers, that affect the participation in social activities, it is considered a limitation at the social level.
The definition of disability is: “a physical, mental or sensory deficiency, be it temporary or permanent that affects the capacity to perform one or more essential activities of daily living and that may be caused or aggravated by the social and economic environment.”
Without the required accommodations and support, disability can cause disturbances at the mental, cognitive, sensory (visual, auditory, taste and olfactory), motor or multiple alterations (propioception, voice or language functions or in other system of the organism).
A person in a situation of disability is any person who presents a limitation to perform an activity or with a restriction in participation due to a health condition.
In the Panamanian law 42 for persons with disabilities, it is established in Article 4 that “a person with disability is subject to its own development, protagonist of its historical growth and primary and fundamental part of his own education, rehabilitation, labour insertion, social and family integration processes.” The concepts of rehabilitation and ability become accessible processes to persons with disabilities that would have the objective of developing dexterities and giving them the elements to compensate disability. The Equalization of Opportunities Law obligates the State to give the equipment and personnel to offer such services, recommends furthering education of the professionals, and promotes research for improving the quality of care. Besides, it mandates the employers of parents and/or tutors of persons with disabilities, to grant them the necessary time to accompany their family members with disabilities to the required treatments. In spite of the fact that the Panamanian population is quite even in regard to gender, almost 50% male and 50% female, just as in other areas, there has been a tendency to discriminate against women. This discrimination is present in all of the country’s activities, from the representation in high government and private enterprise posts, to salary ranges in the different levels of complexity of functions. Another very important issue is the 10% indigenous population. These are seriously deprived socially as well as economically due to their cultural believes and due to the lack of public policies to enhance their opportunities. Consequently a woman, indigenous, and with disability is in frank disadvantage for exercising human rights. The situation of poverty in which most of the population with disability is immersed has a direct relation with access to education, thus it is imperative to offer quality education to them, as is stated in the law of Equalization of Opportunities, in Law 34 of Education and in Regulation 1 of 4 February 2000 which norm inclusive education and curricular adaptations for students with special needs. The plans of the present government regarding education are directed to comply with the legal dispositions regarding inclusion, and for that
purpose has begun a pilot program in 65 schools in the 13 educational regions of the country. A campaign, with TV spots regarding inclusion is presented to the public with the intention of sensitizing the community, by the same token, special training is given to teachers of regular classrooms and meetings are held with parents and tutors to explain the plan. In spite of all these, there are groups in the community, especially among the teachers, opposed to inclusive education and resisting the change. 4. Legal Frame
4.1 National Legal Framework
1. Political Constitution of the Republic of Panama, Article 19: “There will be neither personal privileges nor discrimination due to race, birth, disability, social class, sex, religion or political ideas”. The word disability was added to the above article during the December 2004 reforms. This reform mandates society to eliminate any discriminatory behaviour or action against persons that present disabilities. Since it is in the Constitution it can not be superseded by any Law, norm or decree and it is permanent because constitutions are not changed often.
2. Law 15, 1990 – Convention for the rights of Children 3. Law 1 of January 1992 – Through which persons with auditory losses are
protected. 4. Law 18 of 1993 – Through which the Agreement regarding professional
re adaptation and employment of invalid persons (159 OIT) is approved. 5. Law 3 of 1995 – Family Code – Second Book – Articles 17 and Third
Book 518 present norms for attention of persons with disabilities. 6. Law 34 1995 – Reforms the Organic Education Law. 7. Law 42 of 28 December 1997 – Creates the Ministry of Youth, Women,
Childhood and Family Affairs and within it the National Direction for the Attention of Persons with Disabilities.
8. Law 4 of 29 January 1999 through which there is equal opportunities for women.
9. Law 42 of 29 August 1999 of equation of opportunities for persons with disabilities.
10.Law 38 of 2001 regarding violence in the family and in the home. 11.Executive Order 582 of 1992 that creates the National Commission for
the attention of minors with disabilities. 12.Executive Order 46 of 1998 that establishes the norms for the attention
of persons with disabilities under the principle of equation of opportunities.
13.Executive Order 88 of 2002 through which the Law 42 of equation of opportunities is regulated.
14.Executive Order 103 of 2004 that creates the National Secretariat for the Social Integration of Persons with Disabilities (SENADIS) and the Consultive Council for the Social Integration of Persons with Disabilities (CONADIS).
15.Executive Order of 7 February 2005 that creates the Office for Integral Health for the Population with Disabilities in the Ministry of Health.
16.Executive Order of 9 March 2005 that creates the Office for the Social and Economic Development of the Population with Disabilities in the Ministry of Labour.
17.Executive Order of March 2005 that creates the Office of Equal Opportunities in the Ministry of Public Works.
18.Resolution 04DG/DAJ of November 2004 that creates the Office of Equal Opportunities in the National Institute of Culture.
NATIONAL LEGAL FRAMEWORK
LEGAL DISPOSITION CONTENT INTERPRETATION Constitución Política de
la República. (Modification of
December 2004).
Modification of Article 19 forbids all forms of
discrimination base don disability.
All actions to segregate, coarse or impedes the full exercise of human rights of persons with
disabilities is considered discriminatory and
contrary to the Law. 1951 Law that creates the Instituto Panameño de Habilitación Especial
(IPHE)
Provides specialized and segregated education to children with disabilities.
IPHE is the institution of special education in the country. Even though
the Ministry of Education is responsible for the
education in the country, this institution has
autonomy and administers its own
budget.
Executive Decree 46 of 15 November 1968
Reorganizes IPHE and strengthens special
education.
Children with sensory, motor or intellectual
disabilities must attend special schools, or
special classrooms in the regular school.
Law 15 of 1990
Convention on the Rights of Children.
Children are recognized as persons with rights equal to the adults,
safeguarding their level of vulnerability.
Law 1 of 28 January
1992 Law of Persons with
Auditory Loss. The Department of
selective Placement for Persons with Disabilities
is created within the Ministry of Labor.
Contracting 2% of employees with
disabilities will result in fiscal incentives for
employers. Law 18 of 8 of
November 1993 (Agreement 159 of OIT)
By which the Agreement regarding vocational
rehabilitation and employment of invalid
persons
Promotes employment of persons with disabilities
in justly paid jobs.
Law 3 of 17 May 1995 Family Code, Book II (Minors in specially hard circumstances) Art. 17;
Art. 518. Book III includes participation of persons with disabilities
in social policies
It is the actual norm in family matters. Some
articles could be revised to be updated regarding
the new concepts of disabilities.
Law 27 of 1995, modified by the
Law 38 de 2001
Regarding violence in the family and domestic
violence.
Condemns all forms of violence specially in the
families and in the homes and creates the
mechanisms for protecting the weakest
of the social tissue.
Law 34 of 6 July of 1995 Reforms the Organic Law for Education.
Creates the National Direction of Special
Education in the Ministry of Education to
coordinate the programs of children with special
needs.
Implements inclusive education as a national program. Has a small budget and human resources for the
coordination tasks that must accomplish.
Law 42 of 28 December 1997
Creates the Ministry of Youth, Women,
Childhood and Family and within it the
National Direction for Persons with Disabilities.
Reformed in 2004, the name was changed to
Ministry of Social Development.
Law 42 of 27 August 1999
Law of Equalization of Opportunities for
Executive Decree 88 of 12 November 2002 that
Persons with Disabilities. Declares the integral
development of Persons with Disabilities as a
matter of social interest, in equal conditions of
quality of life, opportunities, duties and
rights as the rest of society with the goal of personal growth and
total social integration. Modifies the Penal and
Labor Codes.
regulates Law 42. there is little knowledge of
persons with disabilities and their families and
even less by the rest of the population. There
has been little enforcement of the norm and no sanctions have
been implemented.
Law 4 of 29 January 1999
Law that institutes equal opportunities for
women.
Includes women with disabilities and
denounces disability as aggravating
circumstances in women discrimination.
Executive Decree of 46 of 28 December 1998
Establishes norms for the attention of persons
with disabilities and adopts dispositions for
equalization of opportunities and support for these
population and their families.
Antecede the Law of Equalization of
Opportunities and was superseded by it.
Executive Decree 103 of 1 September 2004
Creates the National Secretariat for the Social Integration of Persons
with Disabilities (SENADIS) and the
Consultive Council for the Integration of
Persons with Disabilities (CONADIS)
SENADIS becomes the governing office on the
subject of disability, under the Office of the
President.
4.2 International Legal Framework Panama has participated in the main world assemblies regarding human rights, care of persons with disabilities and has subscribed a series of international instruments that have become State compromises and have the strength of law.
1. Universal Declaration of the Rights of Man. United Nations, 10 December 1948.
2. A/Res. 2856 adopts the Declaration of the Mental Deficient Persons. UN 20 November 1971.
3. Resolution for the prevention of disabilities and rehabilitation of disabled people. Social and Economical Council of the UN. 16 May 1975.
4. A/Res. 3447 that approves the Declaration of the Rights of Disabled People. UN 9 December 1975.
5. A/Res. 71/123 declares the Year of the Disabled. UN. 16 December 1976 6. A/Res 179 promotes the Prevention of Disabilities. UN. 14 May 1979. 7. World Conference about the decade of disability in the UN, July 1980,
approves the resolution in favour of women with disabilities without age discrimination.
8. Decade of the UN for Persons with Disabilities, 3 December 1982. 9. RE/1984/26 The Social and Economical Council of the UN regarding the
violation of rights in persons with disabilities, 24 May 1986. 10.A/Res 44/25 Convention about the Rights of Children. UN, September
1990. 11.Agreement 111 of World Labour Organization regarding discrimination in
hiring and occupation signed in 1958 and brought into action in 1960. 12.Resolution 159 and Resolution 168 regarding professional rehabilitation
and employment, World Labour Organization, 1983 13.American Declaration of the Rights of Man, Organization of American
States, 1948. 14.Caracas Declaration, Pan American Health Organization, for the
restructuring of Psychiatric Care in Latin America. 15.Principles for the protection of the mentally ill and for improvement of
mental health, UN, 1991. 16.Inter American Commission for Human Rights in 1997 took knowledge of
Resolution C.D. 40 R19 of PAHO/WHO inviting all States to improve legislation for the protection of the rights of persons with mental disabilities.
17.Inter American Convention for the Elimination of all Forms of Discrimination based on Disability. OAS, 7 June 1999.
18.World Declaration on Education for All. Jomtien, Thailand. 1990. 19.Salamanca Declaration regarding special needs in education, 1994. 20.Montreal Declaration about the rights of persons with intellectual
disabilities, PAHO, October 2004. 21.Declaration of Cartagena, Colombia 1992 22.Declaration of Managua, Nicaragua, 3 December 1993 23.Agreement of Antigua, Guatemala, 1995 24.Agreement of ATLAPA, Panama, 1995 25.Agreement of Montevideo, Uruguay 26.Agreement of Mexico, 1995 27.Agreement of El Salvador.
LEGAL INTERNATIONAL FRAMEWORK
ORGANISM DOCUMENT CONTENT INTERPRETATION UN, 10
DECEMBER 1948
Universal Declaration of the Rights of
Men.
Recognizes the inherent rights of
human beings
Condemns all violence or
discrimination against individuals by governments or
social groups or other human
groups. A/R 2856 UN 20 November
1971
Declaration of rights of
persons with mental
deficiencies.
Recognizes the rights of persons with intellectual
deficiencies.
Promotes respect toward persons
with disabilities and intellectual deficiencies.
UN – Economical and Social
Council 16 May 1975
Resolution for the prevention
of disabilities on handicapped
persons
Gives the signing Status the
responsibility of preventing
disabilities in their countries
Gives support to the persons with
disabilities and the Status in programs
for persons with disabilities.
A/Res 3447 UN– 9
December 1975
Delegation of rights of
persons with disabilities.
Recognizes the rights of persons with disability to
enjoy social wealth.
A/Res/71/123 UN16
December 1976
Declares the International
Year of Handicaps.
The United Nations declare to dedicate a year call attention of the World toward
persons with disabilities.
The International Year for Handicaps promotes visibility
of this population at world level.
A/Res/179 UN–
Economical and Social
Council - 14 May1979
Promotes prevention of
disabilities
Continued efforts to prevent disabilities.
World Conference about the
decade of the United Nations
1980
Measures against
discrimination of women.
Recognizes women as objects of violence and
discrimination especially women with disabilities.
In their efforts to be recognized
include the axis of women with disabilities.
A/Res 37/52 y A/Res 3753 UN – 3 December
Decade of the United Nations
for the
World Action Program for Handicapped
To obtain better results in the
subject of disability,
1982 Handicapped the UN dedicates 10 years to the
programs for this population.
A/Res 44/25 anex 44 U.N.
GAOR - A/Res 44749 UN –
1989
Convention for the rights of
children
Vulnerability of children is
recognized and their rights are
proclaimed
This Convention has been the basis for the laws and dispositions in
favour of children in the country.
Convention 159 - OIT -
1983
About vocational
rehabilitation and
employment of handicapped.
Recognizes the right to work for
persons with disabilities.
Poor compliance.
Recomendation 168 de OIT –
1983
Regards professional rehabilitation
and employment
Poor compliance.
Agreement 111 OIT -
1960
Relative to discrimination in regard to work and
occupation.
Poor compliance. The Law 42 tries to
minimize discrimination due
to disability.
OAS - 1948 American Declaration of the Duties and Rights of Men.
All countries in America recognize that all men are
equal and have the same rights.
It is the basis for the legislation
related to enjoyment of rights for all people in the
country.
PAHO -1990 Declaration of Caracas
Promotes restructuring
mental care in Latin America
It is the starting point for the
revision of mental health care policies.
UN - 1991 Principles for the protection of the mentally
ill and improvement of mental health.
Adopts principles to insure the integrity
and respect of rights of the mentally ill.
It is a call of attention regarding mental health care
condition.
UN - 1994 Standard Rules for Equalization
Is the most complete group of
Even though it is not legally binding
of Opportunities for Persons with
Disabilities
norms of human rights for persons with disabilities
it is a morally binding instrument
because of its contents in human rights and because of its monitoring
mechanisms. CIDH - 1997 Resolution
CD40 – R19 Exhorts States to
improve the legislation on
protection of the rights of the mentally ill.
Persons with mental illnesses are
included in the legislation of disabilities.
OAS - 1999 Inter American Convention for the elimination of all forms of discrimination
for persons with disabilities.
Mandates the Status to avoid discrimination
toward persons with disabilities and to dictate legislation
and public policy on the subject.
Condemns all segregation or
impediment for the enjoyment of social wealth, base don
disability.
Jomtien, Tailandia,
March 1990
World Declaration of
Education for All
Establishes the right of all children to attend school.
Gives the lines for meeting special
needs in education.
Salamanca España- 10 June 1994
Salamanca Declaration.
World Conference on Special Needs in
Education.
It recognizes that children with
disabilities may have special needs.
Montreal, Canadá –
October 2004
Montreal Declaration on
Intellectual Disabilities
Revises the paradigm on disability and
strengthens the rights of persons
with intellectual and mental disabilities
Promotes participation and independance of
persons with intellectual
disabilities, with recognition of their rights and respect to their decisions
Cartagena, Colombia – 30 October 1992
Declaration of Cartagena de Indias
Re afirms the norms regarding
prevention of disabilities and integration to
society and to work of persons with
physical, sensory or mental limitations.
Managua – Nicaragua – 3 December 1993
Declaration of Managua
Framed on a vision of the right to enjoy social wellbeing it
presents the development of
social policies for children with disabilities
It was subscribed by 36 countries and sets disability as a human rights issue.
Antigua, Guatemala –
1995
Compromiso of Antigua
Reinforces the need to comply with
Managua’s Declaration.
Reinforces the need to sensitize society and to respect the rights of persons with disabilities.
5. Administration and organization of the subject of disability
In 1998, the Panamanian government created a new ministry for the attention and care of the most vulnerable groups of society. This was the Ministry of Youth, Women, Children and Family, whose name was recently changed to Ministry of Social Development. One of the Directions at national level has the task of specifically watching for the population with disability in the national territory, without differences due to gender, ethnic group, age, geographical location, religious creed or political ideology. This Direction organized the public policies regarding disability and in its first year rescued a law project, elaborated by the civil society, and brought it to ample consultation with all involved. Finally, the 27th of August of 1999 the Law of Equalization of Opportunities for Persons with Disability became officially a Law of the Nation. This instrument nourished from many sources such as the Family Code of 1995, Law 34 of Education that promotes inclusive education, a 1951 Law that creates the Institute for Especial Rehabilitation, Law 1 of January 1992, known as the Law for persons with auditory loss, the Municipal Agreement of 10 February 1998 that regulates the elimination of architectural barriers in public use areas. From 1 September 2004 the subject of disabilities takes a very important turn. In the Ministry of the Presidency, but directly under the Presidents Office, a
new Secretariat for the Integral Attention of Persons with Disabilities (SENADIS) is created. This office has the primary function of coordinating the actions of the different government institutions regarding disability, in order to insure efficient and prompt attention, avoid duplication of services and optimize resources. SENADIS serves as technical secretariat to the National Consultive Council for the Integral Attention of Persons with Disabilities (CONADIS) which is formed by the Ministers and Directors of State institutions that impact disabilities, representatives of organizations for and of persons with disabilities, private enterprise and non government associations related to the subject. Among its functions, CONADIS has to create and put in effect the National Plan for the Integral Attention of Persons with Disabilities. This plan is ready and will be presented to the President shortly. Among the most important achievements of SENADIS we can mention:
• Public buildings accessibility program, starting by setting ramps in the interior and exterior of the Presidential building. Since this is a historic monument, declared by UNESCO, the ramps are mobile.
• Installation of the Office for Equal Opportunities in all government
offices. Presently there are such offices in the Ministry of Health, National Institute of Culture, Ministry of Labour, Ministry of Public Works, and the Ministry of Housing. In some instances the structure of an office to attend women issues was used, with a change in name to give it a wider scope of action, becoming the Office of Equalization of Opportunities.
• Besides the office buildings, the airports, hospitals and health care
centres are eliminating barriers through a program in conjunction with the Fund for Social Investments and the institutions own resources.
• In conjunction with the Ministry of Education a program to make
Panamanian education inclusive was put in effect. There is some resistance from special teachers, regular teachers and parents, but the program has a strong component of training and information that is intended to diminish the apprehensions proper to all changes.
• With the First Lady’s Office a campaign to sensitize the public with
respect to inclusion was launched. The name is INCLUYE and consists of billboards, TV spots, literature as of why it is important to integrate the persons with disabilities and their families in all social and community activities. To finance this campaign, besides the contributions of private enterprise, the elastic, blue bracelets with the word INCLUYE are sold for $2.00.
• The National Plan of Attention for Persons with Disabilities.
• The organization of civil society and groups of persons with disabilities. • Training of persons with disabilities in community participation and
independent living.
• Coordination of a study of prevalence of disabilities in Panama
• Validation of national studies regarding disabilities.
Another very important issue was the meeting of the First Ladies of Central America and the Caribbean that took place in Panama City during the Presidents of the Region Meeting, last July. The theme of the meeting was Poverty and Disability and the wives of the Presidents had the opportunity to exchange experiences and to analyze the subject.
The National Direction for Persons with Disabilities in the Ministry of Social Development has the function of drawing public policies, plans, programs and services for persons with disabilities, inspired in the principle of equalization of opportunities. It guarantees the conditions that permit access and full integration to society. It also promotes assistance and protection for persons with severe dysfunction of their faculties. This Direction coordinated the presentation, before the National Assembly, of the Law 42 of Equalization of Opportunities in 1999 and in August 2004 presented a National Action Plan for Persons with Disabilities, that has the goal of achieving full participation and ample contribution of the population with disabilities in human development, individual or collective with the purpose of improving their living conditions.
5.1 Non government, public and private organizations. The parents and tutors of persons with disabilities have grouped to try to improve the quality of life of their children with disabilities since the decade of the 40’s. The influence and hard work of Mrs Maria de Moreno, mother of a girl with disabilities, as well as of other parents gave way to the creation of the Instituto de Habilitación Especial (IPHE). Posterior to the creation of IPHE other groups of people with disabilities were organized to struggle for the recognition of their rights and for improving social conditions.
There are about fifteen organizations of persons with disabilities and about eleven organizations for persons with disabilities. They all share the objective of improving quality of life and opportunities for participation in Panamanian society.
One of the oldest is the National Union for the Blind, founded 17 November 1962, which counts with 180 active members out of which about 80 are active. This group founded the Rehabilitation Centre for the Blind Andres Cristobal Toro, which trains blind adults.
In the province of Colon there is a Blind’s Club that works in the organization and rehabilitation of the blind in the area.
Patronato Luz del Ciego is another organization, created in 1991 by the Quelquejeu Family, it is a private NGO that has rehabilitation programs for people with low vision or blind.
At the University of Panama, the graduated and active blind students have an organization that manages special programs for the blind at the Simon Bolivar Library and in an internet café. They also have an association for sports comprising swimming, chess and athletics. In the interior of the country they have associations for the blind, some are already functioning and others are in formation. The National Association for the Disabled (AMPI) has a long history for grouping persons with different disabilities. Through AMPI and the Ministry of Labour an agreement was signed with the government of Spain for the establishment of small businesses for persons with disabilities.
The National Federation of Persons with Disabilities groups associations of different disabilities and has the objective of improving quality of life and the total enjoyment of the rights for this population, whether they belong to the association or not.
The Christian Fraternity of ill and Disabled Persons (FRATER) is based in the doctrine of the Catholic Church. It is integrated by persons with disabilities, groups many professionals, and has been quite belligerent in respect to recognition of rights and the elimination of all barriers that impede the enjoyment of social welfare.
The National Association for the Deaf achieved the approval of Law 1 of January 1992 that protects persons with auditory loss. This Law gives fiscal incentives to employers that contract persons with disabilities and promotes the improvement of communications and utilization of interpreters for the deaf.
The associations for children with disabilities have grouped in the Federation of Parents and Friends of Persons with Disabilities (FENAPAPEDI – REPA), which was founded on 26 August 1994 and has chapters in Panama, Colon, Chiriquí, Darien, Los Santos, Coclé and Bocas del Toro. They work for inclusion in education, citizen’s participation, continued training for parents, tutors, professional personnel and government employees in the subject of disability. It has a training centre for orientation, emotional support and legal support, has an information centre, and participates in sensitivity campaigns at national level, assists in the prevalence study, in programs for training and information regarding inclusive education and in the educative support, program of especial placement for persons with disabilities and their families. This organization has organized national and international seminaries and meetings
and has signed affirmative actions agreements with the candidates to the presidency of Panama during the campaigns of 1999 and 2004.
Caminemos Juntos (Let’s Walk Together) is a Foundation of parents and other people interested in the subject of disability. It is a NGO founded on 14 July 2001 with the purpose of promoting and giving value to the rights of persons with disabilities, improving quality of life and full inclusion in community activities and the development of independent life. The Foundation provides services of early stimulation, family orientation, psycho educative support, reading, writing and mathematics workshops, sensory motor development, recreation and social welfare besides psychological orientation and legal counselling for the families. The Foundation for the Right of Community Integration (FUDICO) was founded in 1996 and is formed by the relatives of persons with disabilities and technical personnel and has as objective the defence of the rights and the full integration of persons with disabilities.
The Foundation for the Disabled functions through a board of directors that represent local entrepreneurs and persons with disabilities. It promotes prevention and attention of disabilities, cooperates with surgeries and assistive devices, especially for motor disabilities and auditory losses and participates in training programs.
Special Olympics groups children and young adults who present disabilities, mainly intellectual disabilities. Through competition and sports promotes ethical and moral values, discipline, strengthens the feelings of national identity and makes more visible the persons with disabilities through their participation in community activities.
Mary Arias Foundation sponsors programs and gives attention to children with cerebral palsy and offers programs for parental support. This Foundation has constructed rehabilitation centres for children of marginal or extremely poor communities. The Foundation My Immense Value develops rehabilitation programs for children with cerebral lesions, trains parents and caretakers to enable them to participate actively in their children’s programs.
Other parents associations work in matters related to education such as: Association of Parents of Deaf Children, Parents of the School for the Deaf, Regional Association of families and friends of Persons with Disabilities, Parents Association of Special Education, and Federation of Parents of Central Panama. Of recent creation are the Foundation I have my Space, NGO Happy Children and the Foundation of Osteoporosis.
The Association of families and friends of Persons with Schizophrenia and Mental Diseases offers support to relatives of persons with mental disease. In
Panama, the patients with mental disease struggle to get recognized as persons with disabilities. The professional organizations of Physical, Occupational and Speech Therapies have programs on the new concept of disability. In the Universidad Especializada de las Americas (UDELAS) the concept of disability is included in the formation of Physical Therapists as a contribution to the upcoming professionals, but it is not officially included in the study plans of all careers related to the care of persons with disabilities, as it would be recommended.
Some Civil Clubs cooperate with persons with disabilities. 20-30 Club, for example has raised money through telethons to sponsor the construction and equipment of the Centre for Rehabilitation of the Disabled, today known as the National Institute of Physical Medicine and Rehabilitation and this year they project to give a part of their funds to the building of community centres for the attention of persons with disabilities. The Rotary Club and the Lions Club also sponsor some programs in the field.
5.2 International Cooperation Actions in Disability
The international cooperation actions in regard to disability programs are scarce and have been directed mostly to training and technical counselling. With the Ministry of social Development and SENADIS more punctual actions are being developed:
Organism Project Actual State
Red Intergubernamental iberoamericana de
Cooperación Técnica (RICOTEC) (Organismo de IMSERSO, España)
Technical assistance and training, coop and co financing of projects
for persons with disabilities.
In effect
Fondo Argentino de Cooperación
Internacional (FOAR)
Technical assistance for the elaboration of the
National Plan for persons with disabilities
In effect
Organización Mundial de la Salud/ Organización
Mundial de la Salud (OMS/OPS)
Technical assistance of 5 consultants for the
National Office of Integral Health and the Study of Prevalence of
Disabilities
In effect
OMS/OPS Certification and validation of the CIF by
a Peruvian expert
In effect
Banco Interamericano de Desarrollo (BID)
Finance training of teachers of the regular
system in the pilot
In effect
schools for inclusion Organización de Estados Iberoamericanos (OEI)
Exchange of technicians and experts from
Mexico and Costa Rica.
The agreement was signed and the first
consultation is planned. Fondo Rotativo de Préstamos para personas con discapacidad
(OIT/Gobierno Español)
$40,000.00 donated by OIT & $72,000.00
donated by the Agencia de Cooperación
Española & Instituto de Migración y Servicios Sociales de España.
In effect
Agencia de Cooperación Andaluza (España)
Education and labour insertion for San
Miguelito & Colon.
Elaborated, presented, awaiting answer.
Fundación Real Madrid (España)
Social integration schools
Agreement signed project in elaboration
for presentation. Genralitat Valenciana
(España) Universal accessibility Agreement signed for
Project of accessible beaches in effect, awaiting visit of
Valencia officials to design new project.
Ayuntamiento de la Coruña (España)
Technical exchange Date of visit to Panama in study.
Fundación Once (España)
Learning support for blind or low vision
students in the inclusive schools.
Pre approved, answer pending to new
document requested by FO.
Banco Interamericano de Desarrollo (BID)
No refundable funds for mission trips for
members of SENADIS and consultation of
Strategic Plans.
In effect
Fundación Cable and Wireless (Panamá)
Equipped rooms for inclusive education.
In effect
SOI (Olimpiadas Especiales)
Unified sports for Special Olympics
Agreement signed and in effect.
Fundación Telefónica (Panamá)
Technology for inclusive schools
In effect
Fundación 20 – 30 Building of rehabilitation centers in rural and
marginal areas
Approved and in effect
Rehabilitación Promotion of micro Investigation phase for
Internacional businessmen with disabilities
elaboration of project
Fundación Kennedy (USA)
Training of special ed. and regular ed.
teachers
Presented and awaiting answer
SENND AMERICA Exchange of professional practices
In effect
Médicos de la Paz Prosthetics and orthetics
Project elaborated and ready to be presented
Partners of the Americas
Fellow of the Americas
In project
Handicap Internacional Professional and vocational rehab of
persons with disabilities
In project
Source: Ministerio de Trabajo y Desarrollo Laboral, Ministerio de Desarrollo Social, Ministerio de Salud, SENADIS. 6. Profile of Persons with Disabilities in Panama
The statistics about disability present a marked under registry regarding the information in general since the disabilities reported are the most obvious for the interviewer.
There is a question, elaborated in 1998, regarding disability included in the National Census. The training given to the interviewers made it possible to obtain more precise data than in previous census regarding the situation and profile of persons that present disabilities, but it is quite far from being objective. The numbers of the last National Population and Housing Census of 2000 don’t get even near to the estimates of organisms such as the Pan American Health Organization (PAHO) that refers to approximately 10 to 15% of the total population.
Considering universally accepted factors causing disabilities, such as malnutrition, high risk pregnancies, unattended deliveries, traffic accidents, violence, use and abuse of psychotropic substances, complicated by poverty, social inequities and little access to basic services, is necessary to refer to the figures reported in the Census as the official numbers with the consideration that a more precise measurement is pending to identify how many are there, where are them, their access to education, health, labour and public installations, among others. SENADIS is actually conducting a study to detect the prevalence of disabilities in the Panamanian population. The study is inter institutional and counts with the participation of university professors, personnel from the National Comptrollers Office and the different Ministries and Government Institutions.
The persons with disabilities are among the poorest in the country. Statistics reveal that 27,330 out of the 52,197 persons with disabilities do not receive an income, 8,466 receive less than $124.00 per month, 9,617 receive less than $600.00 per month, and 1,872 have incomes between $600.00 and $3,000.00 per month. From 1992 to the first semester of 2005 1,480 persons with disability have applied for employment at the Ministry of Labour and they have been able to place 313 persons. Of the total number of persons with disabilities in the country 9,997 have jobs and 42,200 do not.
In the national population the index of occupation is 60% and among the persons with disabilities is 25%.
In Panama there are two entities in charged of training and placing persons with disabilities: the Goodwill Industries and the Special Vocational School that belongs to IPHE.
Access to health is inadequate because resources are inadequate. In the area of human resources there are 0.08 physiatrists, 1.28 physical therapists, 0.34 P.T. assistants, 0.32 occupational therapists, 0.35 speech therapists, 0.01 orhtesists/prothesists and 0.04 respiratory therapists per every 10,000 inhabitants. The highest concentration of professionals is in the urban areas where there is a greater concentration of persons with disabilities (30,845) while in the rural areas it is estimated that the breach increases due to the fact that less disabilities are reported (20,787) in spite of greater risks due to malnutrition, lack of health care and job related accidents, just to name a few factors. Regarding education, which is perhaps the aspect more taken into account for the population with disabilities, according to the Census of 2000 there is 27.5% illiteracy among the persons with disabilities while the percentage for the rest of the population is 7.6%. The education received by the children in the special system is deficient if compared to the regular system, which makes their access to higher education extremely difficult. The population with disabilities has poor visibility in society because it has been excluded of the social and economic programs of the country. This consequently generates a poor management of numbers to account for their real social and economic condition.
PERSONS WITH DISABILITIES IN THE REPUBLIC OF PANAMA CENSUS DATA OF 2000
TOTAL POPULATION at 1 de July
2003
3,116,277
WOMEN
1,543,427
MEN
1,572,850
PORCENTAGE OF THE TOTAL
POPULATION 100.0
Total of
Persons with disabilities May 2000
52,197
22,961
31,258
1.8 Source: Data from Contraloría General de la República.
PERSONS WITH DISABILITIES ACCORDING TO THE TYPE OF
DISABILITY ACCORDING TO CENSUS 2000 DATA
TYPE OF DISABILITY
URBAN AREA RURAL AREA TOTAL
Physical Deficiency
7,007 4,585 11,592
Mental Retardation
5,969 4,216 10,185
Blindness 4,488 3,493 7,981
Deafness 4,143 3,531 7,674
Cerebral Palsy 2,512 1,292 3,804
Other 6,726 3,670 10,396
Not declared 413 152 565
TOTAL 31, 258 20,939 52,197
Source: Contraloría General de la República. Censos Nacionales de Población y Vivienda 2000
These numbers represent the disabilities reported during the census. It is necessary to note that many of the surveyors lacked skills in the subject and perhaps could not discriminate between moderate and mild therefore they reported only the most visible ones.
The 1.8% of the total population is not even statistically significant thus it would not require the elaboration or application of programs to improve care because the results would be quite good. Nevertheless this numbers are quite far from the reality experienced by the population with disabilities and their families and the professionals that work with them, since there are serious deprivations in their insertion to society and enjoyment of their rights as humans, which include the most basic, such as access to health, education and work. The Pan-American Health Organization, OPS, recognizes that world population with disabilities present marked disadvantages in regard to participation in society which contributes to make it a high risk group, subject to inequities,
violence, discrimination and impediments to access health care, education and work, therefore precluded from the full enjoyment of their rights as human beings. The levels of disease, illiteracy and unemployment of the population with disability are markedly higher than those for persons without disabilities, yet the programs to reduce poverty and exclusion breaches have given little space to the population with disabilities and mostly are in programs apart from the rest of the population.
A population that is minimally considered in the strategists to reduce poverty will have to continue being poor, in spite of the isolated efforts of professionals of all branches of knowledge making diagnostic studies that end up being only a futile exercise of the intellect. It is the turn of the governments to assume their responsibility of recognition, protection and inclusion of the population with disabilities in the programs for the rest of the population. It is incredible that in the XXI Century we are still talking about programs for persons with disabilities when what should be done is include the axis of disability in all national action programs y stop doing more of the same, even though it is done with good intentions. The access to education has to be for all children of the country regardless of their disability, the access to a justly paid job should be through merits and not through programs that deepen the discriminatory behaviour that persist in all levels of society, and so on and so forth for all the basic human rights.
World Statistics on Disability according to PAHO
TOTAL NUMBER OF PERSONS
WITH DISABILITY
IN THE WORLD
600,000,000 ATTEND SCHOOL
DO NOT ATTEND SCHOOL
2% 98%
ACCESS TO BASIC
SERVICES
HAVE NO ACCESS TO
BASIC SERVICES
2% 98%
ACCESS TO EMPLOYMENT
HAVE NO ACCESS TO
EMPLOYMENT 20% 80%
Source: Organización Mundial de la Salud/ Organización Panamericana de la Salud.
This 20% of the world population, as we can see, is a considerable number that should not be treated with complaisance by the authorities and by society in general. The national programs and the international cooperation should focus on the problem integrally, just as it is proposed by the International Classification (CIF), taking into account that human beings are part of an environment and therefore this environment impacts their quality of life. 7. Public Policies about Disability in Panama
The Ministry of Social Development (formerly named Ministry of Youth, Women, Children and Family) has the mission of planning, promoting, organizing, directing, developing, coordinating, executing and following up on the application of public policies relative to persons with disabilities. This task is executed through one of its directions in the national level: the National Direction for Persons with Disabilities.
This office assumed the task of compiling the legal norms that were dispersed in the different legal bodies of the country, of coordinating and giving support to the groups of and for persons with disabilities in the presentation of a Law Project about equalization of opportunities, of coordinating actions with other institutions, of stimulating the participation of key actors of society in order to elaborate the National Action Plan and of trying to include the axis of disability in the country’s social development plans.
With the creation of the National Secretariat for the Social Integration of Persons with Disabilities there is an improvement in coordinating activities of the public sector toward persons with disabilities, with more agility since SENADIS is given a higher rank and its director is invited to the Cabinet.
The National Council for the Social Integration of Persons with Disabilities is presided by the President of the Republic and formed by the Ministers of State, the Directors of the main institutions of the public sector, the churches through the Ecumenical Council, the organizations of and for persons with disabilities, the civic clubs and persons interested in the subject may assist. It is a modern initiative that gives hierarchy to the subject at the highest level of government and civil society to discuss and adopt policies and actions for the benefit of this population.
Regarding public policies, Panama has a legal body that protects persons with disabilities and their families in all areas of activity from a human rights perspective.
In December of 2004, the National Assembly modified the Political Constitution of the country. Among the modifications was included the Article 19 that recognizes disability as an element that can not be utilized to discriminate a
person. All actions and policies, since the date of such modification, have to eliminate disability as a reason or cause to segregate o impede the full exercise of human rights, whether they refer to health, education, work, social security, information or access to public spaces. Other articles of the Political Constitution that protect all citizens and therefore all persons with disabilities are: Art. 52, 55, 56,102,106 and 109. The Family Code, which was put into effect in January of 1995, frames the fundamental principles of duties and rights for all members of the families, and among them the persons with disabilities. This Code identifies this group among the vulnerable populations and protects them through articles 390, 404, 405, 406, 517, 518, 519, 520, 521.
The main object of all these legislation and of the State instances created or reformed to care for the persons with disabilities is to enforce the focus on the person and not in the disability, is to promote the acceptance of diversity and of inclusion, therefore guaranteeing social equity.
7.1 Indicators After consulting the statistics of Panama and utilizing the document of Rodrigo Jimenez for the elaboration of a diagnosis regarding the enjoyment of rights of persons with disabilities, the following indicators are proposed: 7.1.1 Access to physical space Panama is not friendly to persons with disability regarding access to physical space. The growth of the cities has been due to the population increase and not to urban development plans. Thus there are areas of high concentration of population and many empty spaces in others.
The streets present poor security for crossing; the presence of sidewalks is scarce in the residential and commercial areas of the cities. In many commercial areas, the few existing sidewalks are used by owners as an extension of their stores. In the suburbs sidewalks are almost non existent.
There are no ramps to accede to sidewalks. Bridges and areas for crossing have stairs. There is only one such bridge that has a ramp on one side and stairs on the other.
There are no street lights with sound. Presently SENADIS, through funds from the Social Assistance Fund is trying to acquire four sound street lights to be installed in important avenues of Panama City.
The buildings constructed after the Municipal Agreement of 10 February 1998 are more accessible for persons with decreased motor function and for the blind. The Law 42 of August 1999 adopts all the dispositions of the agreement therefore they have the force of law and are obligatory in the whole country. It
is mandated that all public use buildings must comply with the modifications for accessibility approved in the law before they are given the necessary permissions for construction. All public use buildings, constructed before the Law, had a five year period to make the modifications required. Even though there has been an improvement, accessibility is an issue of less than 30% coverage. The new elevators installed in the buildings have numbers in Braille and some announce the floor reached. According to Law 42 of Equalization of Opportunities for every 25 parking spaces, at least one has to be for wheelchair users. In the commercial areas there is about 80% compliance in signalling the space, but in order to prevent other persons to use them, they are blocked with cones, chains, trashcans or any other big and heavy object that impede parking and this measure makes it even harder for persons with disabilities to accede to them. In other cases the security guards of the building will allow other persons to use them. Some quite irresponsible and insensitive people will use them in spite of all the signs. The Law establishes fines for trespassers but there has not been a clarification of how and who is responsible for imposing the fine and for collecting the money. According to the Law the money collected through such fines is to be used in programs and seminars for persons with disabilities. Transportation is another very sore issue; there are no busses or taxis adapted for persons with disabilities. The regular taxis won’t even stop to pick up a passenger in a wheelchair and when they do, they charge high amounts of money to the user. 7.1.2 Complaints before the Ombudsman In the year 2004 three complaints were presented to the Ombudsman, based on the Law 42 of Equalization of Opportunities for Persons with Disabilities.
One was about the Canal Authority, because a parent of a Down’s Syndrome son was denied permission to accompany the child to his treatments; a second complaint was against Cable and Wireless telephone company for firing without justification a person with disability that had worked 16 years for the State company and 2 years in the privatized company and the third complaint was of a wheelchair bound woman, university graduate, that applied for a job position three years ago and was never called for an interview.
The Ombudsman office counts with one person to attend the issues related to disability. There are no known programs to inform persons with disabilities of their rights or the Law 42. 7.1.3 Housing
Until January 2005 there was no housing program, public or private, taking into consideration the needs of persons with disabilities. Through SENADIS, a program with the Ministry of Housing was initiated, to give to persons with decreased mobility and the elderly the ground floor accommodations, as well as a revision of housing plans to adequate and make more accessible the entrances, the halls and the bathrooms. 7.1.4 Education In Panama there are a total of 584,900 students of which 6,879 are reported to present disabilities, which represents a 1.17% of all students. The National Education System has a budget of 432.4 million dollars out of which 13.8 million dollars are devoted to special education in IPHE, representing 3.25% of the total budget for education. The National Direction for Special Education in the Ministry of Education has a budget of 750 thousand dollars per year; for the budget of 2006 they are asking for 4 million dollars.
There are a total of 632 special education teachers in the Instituto de Habilitacion Especial (IPHE). They attend to 9,361 students in the country in a ratio of 15 students per teacher. 14.18% of all regular teachers have been given seminars in curricular adaptations. This number corresponds to 5,000 teachers out of the 35,266 of the whole country. Most of the teachers are in the grammar school level up to the 9th grade. In the country there are about 25 teachers for deaf students, 10 of these teachers also work as interpreters. These 25 teachers take care of about 400 deaf students at the national level that need to learn to read and to write, they only cover 6.25% of the demand. There are only 40 accessible schools in Panama, out of a total of 5,220, which is equivalent to 0.76%. In 2005 an Inclusive Education Plan was put in effect in 65 pilot schools. The goal is to make all education centres accessible to all.
In the Provinces capitals there is capability to receive students with special needs, either in the centre, or for individual attention, partial or full inclusion or in special classrooms. In the rural areas or areas of difficult access there are multigrade schools with itinerant teachers that attend to all population. There are 13 technical support teams, one for each educational region of the country. Each technical team gives support to an average of five schools. These teams are working in the inclusive education plan that for this year is working in 67 schools. The pedagogical document for the curricular adaptations is being validated during the present school year with 2000 students of the pilot schools in the inclusion program. There is no official information regarding this plan yet. There is no information regarding the degree of satisfaction of the students that require special adaptations because the systemic evaluation is being drafted. There is no information regarding students that were given curricular adaptations and were able to pass the tests for first, second and third grade.
Regarding the programs, only in Pre-school the issue of disability is included. It is important to note that this issue is proposed for all other curricular programs, but it has not been implemented yet.
Parents of children with disabilities participate in the education community but the support committees have not been appointed yet, it is expected to have them in full function in every school in 2006.
There is no official information regarding teachers satisfaction related to institutional support for consulting, training and implementation of the norms referent to the rights of persons with disabilities and this is a very delicate issue with teachers regarding inclusion programs.
In hospitals and rehabilitation centres there are no tutoring programs for continuing school work.
Even though parents comment that it is very hard to enrol students with disabilities in the regular system, there are no official registries in this regard. In many schools of the regular system, especially private schools, the students are accepted if the parents agree to provide the special support needed. IPHE was created in 1951 and is recognized as the institution of special education in Panama, therefore parents continue to enrol their children because they think that children with disabilities should go to special schools. The capacity of IPHE to admit all children with disabilities is limited and therefore there are waiting lists of students trying to accede to the special system.
The presidential decree number 1 of 4 February 2000 regulates the Law 34 of Education regarding the norms for inclusive education of students with special needs and reinforces the rights of these students to accede to the education centres of their community in the regular system. There is no information regarding the degree of satisfaction of students with disabilities with respect to the education received. As a matter of anecdotes the families of deaf and blind students are satisfied with the rehabilitation received in IPHE. Other disabilities have more difficulty in furthering their education or inserting in the regular system. In the program of inclusive education that started this year in the 13 educational regions, there are 1798 children with disabilities participating and there are 1691 regular teachers; these 1798 students represent 3.93% of the 45,698 total students that attend the schools participating in the program. 7.1.5 International Classification of Function, Health and Disability (CIF) The Ministry of Health and the Pan American Health Organization offered in August a three day seminar for health care providers, medical records personnel and other professionals to initiate the utilization of this scale in the area of disability.
7.1.6 Community Based Rehabilitation: The organizations of parents and friends of persons with disabilities, the Physical Therapy Association and the Social Security have given seminars in the subject but the program has not been given the institutional support needed. There are no records of attention given in the program therefore it is assumed that there has been little advancement in the matter. 7.1.7 Health To attend the health needs of persons with disabilities the country counts with the following registered personnel:
Specialty Total For every 10,000 inhabitants
1. Physiatrists 26 0.08 2. Physical Therapists 400 1.28 3. Physical Therapy Aides 107 0.34 4. Occupational Therapists 100 0.32 5. Speech Therapists 110 0.35 6. Prothesists - Orthesists 5 0.01 7. Respiratory Therapists 12 0.04
The careers related to rehabilitation were not given in Panama until the year 2000 when Universidad Latina graduated the first group of Physical Therapists. Prior to that date all professionals were formed in universities in Latin America, the USA and Canada. Presently the Universidad Especializada de las Americas (UDELAS) forms physical, occupational, speech and respiratory therapists. The assistants and aides are formed on the job in short courses in the Social Security.
The Ministry of Health and the Social Security are the principal institutions for rehabilitation services. All private hospitals have PT and RT services but the access to the services is limited by their economic resources. The present models do not offer prompt attention or early intervention, treatments are not given in the frequency needed, there are no treatment protocols except for a few orthopaedic post operative care and for cardiac rehabilitation. The medical references lack follow ups from the referring provider; documentation of visits and treatments is deficient. In some services, especially in the Social Security the therapists have no access to the patients records and they work solely with the medical reference, they do not document treatments given or patient reaction after each visit, in many places they only write once a week. There is very little team work, with professionals participating in medical rounds or assisting to conferences and case
presentations. The therapies become more expensive due to the unnecessary close supervision of physiatrists that do not let the therapists use their professional criteria to change, increase or discontinue treatments according to patient’s response. This model rather than giving quality care makes access to services a bureaucracy, makes services more expensive, decreases quality of care and doesn’t satisfy the demand. The rehabilitation installations are mediocre. In some hospitals the facilities are located in upper floors making access very difficult; spaces are reduced for the demand; the equipment is obsolete and there is shortage of personnel. Services are clogged with consults and visits of chronic patients that could be on home programs. The National Institute of Physical Medicine and Rehabilititation give ambulatory care to children and adults but the spaces are small and offer little privacy to users. The reduced personnel accounts for short and spaced visits. Equipment has long years of usage and is not state of the art. This facility is located in Panama City which makes access to persons from the rural areas quite hard and costly. There is a project for this year for construction of rehabilitation centres in peripheral areas to avoid unnecessary travelling for care. 7.1.8 Work There is a remarkable breach between the economically active population with and without disabilities. While the level of unemployment of the persons with disabilities is about 11.8% among the persons with disabilities is higher than 50%. The salaries are lower: of 48,380 persons with disabilities economically active 27,330 report no income, 8,466 earn less than $124.00 per month (less than half of minimal salary), 7,941 earn less than $400.00 per month, 2,825 earn less than $1,000.00 per month, 518 earn up to $2,000.00 per month, 101 earn up to $ 3,000.00 per month and 104 make $3,000.00 and more per month. The Ministry of Labour assigns to the Department of Social Integration of Persons with Disabilities 0.59% of the Ministry’s annual budget ( of $28 million it assigns $173,000.00). Since 1992 this department has received and processed 1480 applications for employment and has been able to place 313 persons. Goodwill Industries, NGO manned by a board of directors, reports that it has been able to place 98 persons in 2001, 86 in 2002, 196 in 2003, 503 in 2004 and 250 in the first semester of 2005.
The Labour Ministry keeps no records of persons with disabilities re installed in jobs or the ones that request to be placed in other positions; they have no information on the labour adaptation services offered or of the persons that request to be reinserted in the job market.
The Law of Equalization of Opportunities provides fiscal incentives to employers that hire persons with disabilities and fines those that refuse to hire at least 2% of the workforce of their businesses. There is no record of ever giving such
fine but there is record in the Ministry of Economy of the incentives claimed by businessmen that employ persons with disabilities. In 2002, 16 natural entities received $16,762.16 and 21 legal entities received $171,049.78; in 2003, 32 natural entities received $25,261.37 and 23 legal entities received $199.276.54; in 2004, 39 natural entities received $42,937.87 and 27 legal entities received $199,260.92. There are no registries of persons with disabilities looking for employment informed of their rights, or of the number of such persons looking for jobs that are not hired based on their disability. Even though it is not documented, the population with disabilities perceived a clear discrimination in hiring which is prohibited by the Constitution and the Law. In regard to salary there are marked differences between the population with and without disabilities. The Pact with Commerce enables businesses to hire persons with disabilities with salaries under minimal wages and this is forbidden by the Law. Persons with disabilities have little access to credit for small and medium size businesses and they always have to join persons without disabilities due to the credit requirements requested by financial institutions. There is a fund sponsored by the government from Spain that has given 158 small credits, with a top sum of $2,500.00 for micro businesses. There is no record of the degree of satisfaction of this fund or other financial services. The Ministry of Labour can not supervise or inspect the conditions of contracting and employment of persons with disabilities due to lack of inspectors, lack of knowledge on the subject and lack of coordination with the Ministry of Social Development. There is no information regarding the degree of prejudice in contracting in the public or private sectors, but the numbers of persons employed and the salaries paid to them speak on their own.
The Ministry of Labour has a training program of $3million 700 thousand dollars for persons older than 18 years of age and has allotted 10% for training of persons with disabilities.
Businesses can request consultants and training on the subject to the Ministry of Labour and has been giving an average of 120 such courses per year. 8. Human Rights of the persons with disabilities
8.1 The situation of enjoyment and exercise of human rights among persons with disabilities In the last decade the situation of persons with disabilities has become a subject of interest for the government therefore there are evident changes regarding access and enjoyment of their rights.
Since the approval of the Family Code in 1995 all sort of actions directed to the person and not to the disability or limitation, begun to take place. The national legal norms that frame the programs for persons with disabilities were approved and the most important international agreements on the subject were subscribed. If the government has as part of the agenda the subject of disability it is easier and faster to see positive results that impact the quality of life of the persons with disabilities.
The creation of the National Direction for Persons with Disabilities in the Ministry of Social Development (formerly Ministry of Youth, Women, Children and Family), places this population among the risk groups identified by the State as groups in need of priority attention. The scope of the functions of this office includes all aspects of human care, but since the office is within a Ministry, it is dependent on the interests of the Minister’s working programs and lacks the autonomy to make the necessary transformations. The creation of SENADIS (national Secretariat for the Social Integration of Persons with Disabilities) directly under the President’s Office, and of CONADIS (National Council for the Social Integration of Persons with Disabilities), in which the Ministers of the Social Cabinet and the heads of the main public institutions sit next to the representatives of the organizations of and for persons with disabilities, the businessmen and the representatives of the civic clubs and the churches constitute a guarantee for the opportunity to make the needed transformations related to the subject from the government to the civil society and from the civil society to the government. The campaigns to sensitize society regarding disability such as INCLUYE (include) give visibility to the matter, present the population with disability as important part of the family and of society and strengthen the concepts of integration and participation with emphasis in human rights. The decentralization of the rehabilitation services through Project REINTEGRA (Re integrate) will be possible through the provision of equipment and human resources in the centres of primary care. The Centre for Attention of the Handicapped, which services covered persons with disabilities up to 22 years of age, became the National Institute of Physical Medicine and Rehabilitation in 2001, and has no age limitation for care. This constitutes an advance in rehabilitation and overall care of the population with disabilities. The establishment of offices of equalization of opportunities for the attention of the persons with disabilities in the public sector, such as Ministries of Health, Labour, Public Works, Housing and Culture, is also a big step in the right direction assumed by the government.
SENADIS in conjunction with the General Comptrollers Office, the University of Panama and the Ministry of Economics are elaborating, for the first time with the entire scientific rigor required, a study of the prevalence of disabilities in Panama which is meant to be the basis to all plans, projects and programs in the subject. The Electoral Tribunal of Panama, has set up campaigns since 1998 to encourage persons with disabilities to register in a special roster to allow an appropriate designation of voting centres, free of barriers mainly for persons with impaired or decreased mobility. The response has been inadequate to make the necessary accommodations. In the case of the aging persons, the identification number corresponds to age and it has made easier the task of assigning them to barrier free areas, but for persons with other disabilities is quite hard to assign them to centres that meet their needs. The persons with low vision were offered in 1998 ballots in Braille but they refused them stating that it would make their vote recognizable and easy to identify the group’s political inclination thus eliminating the secrecy of the vote. According to the Law, persons with severe disabilities and the blind can be accompanied by a person of their trust when they cast their vote. Inclusive education counted with regulations and the legal framework, but now with the pilot plan it is put into effect in 65 schools of the 13 educational regions of the country. This plan has the objective to enrol children in the regular school nearest to their home. The plan is backed by numerous parents that belief that inclusion should start in the schools. The resource rooms are sponsored by businesses and private organizations that support this initiative. The Universidad Especializada de las Americas (UDELAS) is the fourth public university and it offers careers in rehabilitation such as physical, occupational, speech and respiratory therapies, learning difficulties, early stimulation and special education. There is quite an opportunity to introduce the axis of disability in all careers offered by the university. The Office of the First Lady sponsors SENADIS programs and the sensitivity campaigns from a perspective very far from welfare or charity. This Office has been instrumental in the inclusion program and in getting the resources to implement it, in international cooperation and in the improvement of inter institutional relations in regard to disability. The increasing number of natural entities and businesses that received fiscal incentives for contracting persons with disabilities indicates a slow but sure advancement in the subject. The organizations of and for persons with disabilities have increased their membership and have been leaders in very important actions to promote citizen’s participation and social integration of this group.
8.2 Principal obstacles that impede the enjoyment and exercise of the human rights of persons with disabilities In Panama the subject of disability was traditionally treated from a medical model with strong tendency to welfare which has impede the social, economical, cultural and political integration of persons that present any type of functional limitation. Errors and horrors have been committed in trying to do the best and protect those who until very recent date have been conditioned or impede to develop their potential or to accede to social wealth in equalization of conditions. Some prognoses have been based in the physical appearance of the individual, his gait, coordination impeding access to the regular school and therefore to a fair and well paid job, restricting the opportunities to be integrated in society. Persons with disabilities have a double struggle to even be recognized by their own families as members, by their teachers and classmates to be accepted as part of the group. They have to fight very hard to pass from one grade to the next, to get a job, to form a family of their own, to participate in politics, sports, and cultural affairs in their community. We marvel when they make it and we most certainly should because society imposes challenges that are very hard to overcome. Since the 80’s, the decade of the handicapped in the United Nations, persons with disabilities have let their voices be heard. In this task they have been accompanied by parents, families, friends and professionals that work in the field as well as by other people that consider the subject quite important.
This visibility of the population with disabilities contributes to sensitize the rest of society, not by arousing pity to hand out the opportunity to accede to social wealth as if it were alms or a concession. Society has to do the necessary changes within it to insure that persons with disabilities become part of it and not continue treating them apart even if we call it positive discrimination. In health:
• In general the health care providers are little sensitive to the subject of disability from the perspective of human rights. The formative programs do not include the paradigm of disability.
• The lack of knowledge of the subject make many health care providers see persons with disability as a group to be treated apart from the rest of the population and deny treatment for common diseases that are not related to their limitation. For example, in some primary care centres, deaf persons wearing hearing aids are sent to specialists for a common cold.
• The health centres are not friendly to persons with limited mobility, not only because they lack ramps, but also because halls and entrances are narrow, examining tables are too high and the clinic space is not practicable.
• In general medications and assistive devices are way too expensive and the State lacks programs to subsidize or sponsor persons with disabilities, even though it is written in the Law.
• Health services in general work with programs that are not very efficient but are very bureaucratic which makes health care more expensive, delayed and untimely in the public sector. Health care is more efficient in the private sector but it is not accessible for majority of the population.
• Persons that present mental diseases are treated apart from the rest of the population with disabilities.
• Rehabilitation Based in the Community is not in effect as a program of the health services.
In education:
• Some parents are not convinced of the goodness of inclusive
education therefore they continue seeing special education as the only chance for their children.
• Regular and special education teachers have much apprehension regarding inclusion and do not make their best effort to make it successful. There is a passive resistance attitude in the best of cases and of confrontation in the worst of them.
• Schools do not have the adequate structures to receive students with disabilities.
• The curricular adaptations do not lead to quality education that allows students to accede to the regular system if they had the capability to do so.
• Segregation persists in the system. • The budget allotted to special education is too high for the
number of benefited students. This money should be used in improving resource classrooms and providing the regular schools with all the implements needed to allow the access of more students in the schools of their community.
• Stigmatization persists and students with disabilities are giving the opportunity to learn crafts as traditionally they were, but they are not offered the fan of opportunities open for them.
In labour:
• Lack of compliance with the Law 42 of Equalization of Opportunities in referral to the hiring 2% of workers with disabilities, in regard to the conditions for contracting, salaries, re adaptation of workers or of jobs.
• The budget of the office for social and economic integration of persons with disabilities in the Ministry of Labour doesn’t allow the hiring of sufficient inspectors to supervise compliance with the Law.
• The contracting conditions are not the same as for persons without disabilities. Businesses are allowed to obviate some social
benefits in order to offer a job. There is discrimination based on physical appearance without considering individual merits or qualifications for the job.
• There are no programs for the job adaptation or vocational rehabilitation in the ministry of Labour.
• There are no mandatory programs for accident prevention on the job or regular risk monitoring.
• The great majority of the workers ignore their rights regarding permanent disability, due to sickness or accident and request to be pensioned rather than reinstated in a job that they can perform.
• The salaries offered to workers with disabilities are lower than the salaries offered to workers without disabilities.
Information and communication:
• There are no phones for the deaf or hypoacusic. • The height of public phones is not adequate for wheelchair users
or little people. • TVs and movies do not offer close captioned system for the
persons with hearing impairments. • Libraries lack material for the blind. • There is no established program or format for communicating
with persons with auditory or language problems with authorities in case of accidents, natural disasters, medical emergencies or criminal attack.
• Public shows, meetings, masses and other services do not count with interpreters for persons with auditory deficit.
• Persons with disabilities continue to be objectified and used to raise feelings of pity, bringing up their limitations and not their possibilities.
• The media utilizes derogatory terms to refer to persons with disabilities (deaf, fool, lame) to refer to persons with disabilities.
• The media in general is not for bringing up the qualities and values of persons with disabilities in a positive context, but enhance the limitations.
In social security:
• The social security system is mandated by law to subsidize for life the children with disability of the insured even after the parent dies. Very few users know about this regulation.
• The social security coverage is limited to those that contribute and their immediate family but there is no similar program for the workers that do not pay social security.
• Private medical insurance has clauses to exclude persons with disabilities.
• The pension’s pay is very low and do not cover the expenses of disability.
• The actual system is not conducive to reintegrating the worker to the labour market.
Access to physical spaces:
• The cities are not friendly to persons with disabilities in their layout or in the access to its constructions.
• There is no compliance with the dispositions of Law 42 regarding accessibility.
• Fines and sanctions established in the Law are not applied. • The axis of disability has not been included in road safety
programs. • There are no inspectors assigned to ensure compliance with
the Law in regard to the special dispositions for persons with disabilities.
• There is not accessible public transportation. 9. Conclusions and recommendations: This diagnosis confirms the state of many situations that have been documented in numerous volumes written on the subject and that constitute very specific reports regarding the degree of enjoyment and exercising of human rights in our Latin American countries. For the consideration of the Japanese International Cooperation Agency and the authorities of the Republic of Panama the most relevant statistics regarding access to healthcare, education, work, transportation, housing, recreation, sports, culture and the physical spaces, are presented. It is quite shocking to see the levels of illiteracy, about 25% in comparison with about 8% for the rest of the population; unemployment for over 50% against 12% for the persons without disabilities, not considering the unjust salary scales and all those that generate some kind of income in the informal economy; the poverty levels among persons with disability in the marginal areas rural and indigenous; the minimal access to healthcare and to assistive devices needed by them; the hostility of the physical spaces and transportation that impede access to social wealth. Inequities regarding disabilities are hard to overcome because society is not conscious or sensitive to existence of behaviour patterns and actions that deepen discrimination, segregation and indifference to the subject. Definitively the action of persons with disabilities, their families and the professionals that care have brought about important changes in the Panamanian society. Proof of this is the recent constitutional change of Article 19, the Law 42 of Equalization of Opportunities, and the creation of the Direction for Persons with Disabilities in the Ministry of Social Development, the creation of SENADIS and CONADIS at the President’s Office, the subscription of international documents regarding disability, the agreements
with private enterprises and professional groups and the international cooperation for technical support given to private and public organizations to and for persons with disabilities.
The compromise in writing of the candidates to the Presidency in 1999 and 2004 did not only manifest their personal interest in improving the quality of life of persons with disability but it also became the compromise of their political community. It was clear that only one candidate was able to win the elections and he would have to comply with his promise as the actual president does, but for the rest of the candidates this compromise became a call of attention on a subject eluded by politicians. To repair the inequities that for so long have affected the population with disabilities it is necessary to make permanent transformations in the systems of attention which favour adaptations to maintain up to date disability care. In health: it is necessary to count with programs for prevention of disabilities; that patient care be given in a timely fashion; that all the population had access to quality services given with efficiency and warmth at all levels of care. Untimely or late care represents more expensive services which in emergent countries constitute an unnecessary expense and the waste of much needed resources. It is imperative to initiate rehabilitation programs based in the community to speed up attention, to give the required continuity and frequency to attain the therapeutic goals and to improve quality of life and the rights of persons with disabilities. A well structured program of RBC contributes to decrease the impact of disability in a person and his family, utilizes existing resources in his own environment and community and identifies the real conditions of persons with disability in the area. Inclusive education must extend gradually to the whole educational system with trained human resources and adequate equipment to become successful. The especial education system should attend only those very severe cases that can not make it in the regular school due to their physical, mental, intellectual or sensory limitation. The labour authorities and the businessmen must comply with the dispositions of Law 42 of Equalization of Opportunities and with international agreements of the World Labour Organization, United Nations and Organization of American States referring to contracting, salary, working conditions and training of persons with disabilities. Communication and information must be made accessible using interpreters and sub titles in TV programs, movies, news, etc. The telephone companies must incorporate the TTY system for use of persons with hearing loss.
The media must revise the language used to refer to persons with disabilities in order to avoid stigmatization and branding through the use of derogatory language. Social security must revise the pension system and the compensations for persons with temporary and permanent impairment to perform their regular duties. The goal should be to provide the best possible benefits for the re adaptation of the job and reintegration to the work force. Permanent pensions should be given only to those workers that because of the severity of his condition can not be reintegrated to work even with modification of duties or occupation. The Law 42 of Equalization of Opportunities proposes job reintegration through vocational rehabilitation before considering retirement due to injury. Transportation, housing and access to physical spaces must be adequate to permit persons with disabilities to participate in the activities liked by all. It is a fallacy to maintain that persons with disabilities have the same rights as the rest of the population if the conditions are not given for their full access, exercise and enjoyment of said rights. In reality if all written norms were obeyed and if all persons with disabilities were seen as a transversal line in all social, economic, educational and health programs of the country, there is no need to make special regulations and offices to give them what they need. Construction of democracy is a continuous task for all. Democracy is not possible if there is persistence of deferential and special treatments that contribute to mark differences, to deepen discriminatory and isolating behaviours and the persistence of treating disability as a welfare issue. Let us not forget that disability touches all levels, ages, genders, religions, nationalities, races, economical situation and political creeds without differentiating or discriminating. The programs for persons with disabilities must be designed from a perspective of integration and inclusion, taking into account all their needs, with vision of the future, of promotion in participation and with a strong base in human rights. It is in the hands of society to make the required corrections to pay for this perverse and unjust social debt that all we all have with the persons with disabilities.
10. Bibliography
Contraloría General de la República, Censos Nacionales de Población y Vivienda. 14 de mayo 220. Dirección Nacional de Estadística y Censo Panamá. Junio 2001.
Ministerio de Economía y Finanazas, Dirección de políticas sociales.
La pobreza en Panamá. Encuesta de niveles de vida – 2003. Principales resultados.
PNUD. La lucha contra la pobreza en Centroamérica. Ricardo Paes de
Barros, Mirela de Carvalho, Samuel Franco, Enrique Ganuza, Rosane Mendoza. PNUD,IPEA,ALFAOMEGA.
Ministerio de Educación, Plan Nacional de Educación Inclusiva, 1999. Ministerio de la Juventud, la Mujer, la Niñez y la Familia, Plan de
Acción Nacional sobre Discapacidad. Agosto 2004. Instituto Panameño de habilitación Especial, Departamento de
Estadísticas Ministerio de Salud, Oficina Nacional de Salud Integral de la
Población con Discapacidad. FENAPAPEDI –REPA , inclusión Internacional. Informe sobre la
situación de la educación en Panamá. Mayo 2004. Ley 1 de 28 de enero de 1992. Ley de protección del discapacitado
auditivo. Ley 34 de 1995 por la cual se legaliza la integración e inclusión de
niñas, niños y jóvenes con necesidades educativas especiales. Ley 42 de 19 de noviembre de 1997 por la cual se crea el Ministerio
de la Juventud, la Mujer, la Niñez y la Familia y en él, la Dirección Nacional de Personas con Discapacidad.
Ley 42 de 27 de agosto de 1999 de Equiparación de Oportunidades para Personas con Discapacidad.
Defensoría del Pueblo de Panamá – Página web. SENADIS entrevistas personales con Manuel Campos, Director
General, Trinidad Hernández, Indira Santos, Aníbal Miranda, Envida Ferrer, Laura Ceballos y Clelia de Arango.
Dirección Nacional de Personas con Discapacidad, Ministerio de
Desarrollo Social. Entrevista con Natasha Velotti, Directora Nacional. Ministerio de Educación, Dirección de Educación Especial
Trabajos de campo sobre barreras arquitectónicas de los estudiantes
de fisioterapia de la Universidad Especializada de las Américas (2000, 2002, 2004).
11. Anexo
• Mapa de la División Política Administrativa de la República, por provincia, comarca y Distrito, año 2000.
• Cuadro. Estimación de la Población total en la República de Panamá, por
Provincia y Comarca Indígena, según anexo y Grupos de edad: al 1ro. De julio de 2003.
• Cuadro. Tasa de fecundidad general en la República de Panamá, según
área, Ciudad y Provincia de Residencia: años 1999-2003.
• Mapa. Tasa bruta de natalidad en la República de Panamá, por provincia de residencia: año 2003.
• Cuadro. Defunciones certificadas por médico en la República, según las
diez principales causas de muerte: años 1998-99.
• Cuadro. Mortalidad perinatal en la República de Panamá, según Ciudad y provincia de residencia: años 1999-2003.
• Cuadro. Víctimas en accidentes de transito en la República de Panamá y
Ciudades de Panamá y Colón, según lugar y clase de víctima: a{o 2001.
• Cuadro. Indicadores demográficos derivados de las estimaciones y proyecciones de la población en la república de Panamá según provincia, comarca indígena y distrito: Periodo 2000-2020.
• Cuadro. Indicadores demográficos derivados de las estimaciones y
proyecciones de la población en la república de Panamá según provincia, comarca indígena y distrito: Periodo 2000-2020. (conclusión)
• Cuadro. Presupuesto del Sector Público destinado a la Educación, en la
República de Panamá, según Institución. Años 1998-2002.
• Cuadro. Matricula de Educación Especial en la República de Panamá, por nivel educativo y sexo, según provincia, comarca, escuela, programa y extensión: año académico 2002.
• Cuadro. Gastos efectuados por el Gobierno Central de la República de
Panamá, según departamento: año 1999-2003.
• Cuadro. Solicitudes y colocaciones del programa. Dirección General de Empleo. Departamento de Integración Socioeconómica de Personas con Discapacidad.
• Cuadro. Ocupación de las personas con discapacidad según tipo de
ocupación: Censo 2000.
• Cuadro. Población de 10 años y más edad con discapacidad, por tipo de
discapacidad, según ocupación: Censo 2000.
Cuadro. Población de 10 años y más con discapacidad, por tipo de discapacidad, según ingreso mensual
