Whether it is Daniel-san in Karate Kid, the Jamaican Bobsled team or Mel Gibson in a kilt, people love to support the underdog. Here’s a feel good story with a simple lesson – in international development, we should often do much of the same.
In Cambodia, it is estimated over 600,000 people with disabilities lack access to basic Speech Therapy services. These are people who have disabilities related to communication and swallowing. They may have had a stroke and cannot swallow food independently. They may have been born with cleft palate, and require surgery and therapy to eat and communicate. They may have Autism Spectrum Disorder, and require communication strategies to interact with their family, friends and community.
Despite this great need, there is a huge lack of services that exist for this population. There is a multitude of reasons for this, but this lack of services can be explained through this (grossly oversimplified) diagram.
At the top of the diagram, there is no explicit mention of disability in the Millennium Development Goals, nor does the UN Convention on the Rights of People with Disabilities mention Speech Therapy services, or the needs of people with communication and swallowing disabilities.
When conventions, laws and policies are not inclusive, this creates the same problems in funding. This affects programs, which in turn affects services. As a result, although no disability organisations in Cambodia could claim to be flush with funding, some of the best funded focus on hearing and visual impairments.
One organization, however, was unable to ignore the needs of 600,000 people needing Speech Therapy services in Cambodia.
CABDICO, a small organisation with 11 Cambodian staff and an annual budget smaller than many UN salaries, went searching for funds to support a program that helped initiate sustainable in-country Speech Therapy services and education.*
Despite the huge need, almost a year of searching provided fruitless. The most common response was “I can see that you’ve raised something very important (for over 600,000 people), yet this area of disability is not our focus and we cannot help.”
When needs are unrecognised at the international level, but felt at the local level, what could CABDICO do?
Larger NGOs often pursue funds that are in the order of millions of dollars. These funds exist because they are in internationally recognised areas of need – education, HIV/AIDs, maternal health, for example. Yet, smaller NGOs like CABDICO, pursuing funds that were closer to $30,000, face tremendous challenges in finding resources.
How do most NGOs respond when then cannot find funding? A good example can be seen through a large and relatively well-funded disability organisation in Cambodia, who, like CADBICO, also recognised the need for Speech Therapy a few years ago. However, due primarily to lack of motivation from funding bodies, they were unable to take steps towards addressing it. Concurrently, they started to develop programs in mother and child health. Why? Due to the availability of funds this area, as a focus of the Millenium Development Goals.
I am by no means suggesting that a focus in mother and child health is unwarranted, nor that this NGO’s work in this area is ineffective. However, the choice this organisation made to pursue available funding affected its ability to be flexible and responsive to the population it serves.
CABDICO, on the other hand, decided to start a funding campaign through the online platform StartSomeGood to offer community-based Speech Therapy services. With these funds, and later, having successfully secured funds through the Australian Embassy, CABDICO began to take steps to address this huge problem.
The first task was to gather everyone who had been doing bits and pieces of Speech Therapy, and those who should know about it, together in the one room. As simple as this sounds, CABDICO had never organised a workshop on a large scale before. It was a daunting task, yet with their can-do attitude, something that they embraced. They partnered with a government coordination body, the Disability Action Council, to help get access to people from Ministries of Health, Education, Social Affairs and Labor, whom they would otherwise have difficulty reaching.
As a result, for the first time ever in Cambodia, people, international and national, governmental and non-governmental, came together to discuss the future of Speech Therapy in Cambodia.
Working groups were set up to address the problem. Buy in from government, so crucial towards success, has begun. Speech Therapy was explicitly mentioned in the strategic plan of the Disability Action Council, but as importantly, in the National Strategic Disability Plan. A Cambodian university that teaches Medicine, Nursing and other Allied Health disciplines has agreed to initiate a Speech Therapy course.
Although there is so much more to be done, the change that has already occurred has happened at breakneck speed, and CADBICO has shown that things can happen like this:
Identifying an unmet need requires going to one place, listening and observing. Anybody can do that. But, often, only small organisations have the agility and capability to do something about what they hear.
In this underdog story, ordinary people generously helped to create change, because those in positions of power wouldn’t. CADBICO’s efforts, and those of countless other effective, small NGOs demonstrates that it doesn’t take millions of dollars to create change, just the belief of the little guy to dare think that things can change for the better.
Addendum: There is still a long, long way to go in this journey. If you would be interested in supporting, in any way, please contact CABDICO.
*I have worked as an external advisor to CABDICO since July 2012.
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