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Bolivia
Key Factors: Disability rights are established by the 1995 Persons with Disabilities Act. Because enforcement agencies are still being created, implementation of the existing legislation is lacking. However, various ministries, departmental governments, and municipalities are beginning to develop policies and regulations, which is hoped will improve the situation.
Likewise, the Ministry of Education now uses "discapacidad" and the expression
"necesidades educativas especiales" (special education needs).6
Definition of Disability
The definitions of disability used in Bolivian legislation resulted from changes in approaches to disability over time. Because early concepts of disability were based on "impediment" and "incapacity," definitions tended to focus on impairments. The act dated 22 January 1957 that created the Bolivian Institute for Blindness stated that "a blind person is an individual with a visual ability of 20/200 or lower or a visual field of 20 degrees or lower, considering the best eye and the best correction."7
With the international development of new frames of reference, Bolivia's concept of disability began to reflect those shifts taking place elsewhere. For example, the International Classification of Impairment, Disability and Handicap (ICIDH) definition of disability is included in the People with Disabilities Act, Law 1678. According to the text, a disability is "any restriction or lack, resulting from an impairment, of ability to perform an activity in the manner or within the range considered normal for a human being."8 The Standard Rules on the Equalization of Opportunities for Persons with Disabilities, adopted by the United Nations in 1993, also served as important guidelines for the drafting of legislation and official documents.
However, population measurement instruments in Bolivia continue to rely
on ideas about disability based on individual impairments. All survey questions
about disability present respondents with a short list of impairments that implicitly
define disability. This impairment-based approach is common among the general
population making such questions easy for interviewers to ask and respondents
to understand. However, this narrow definition of disability does not conform to
the newer legislative framework and likely resulted in a deflated estimate of the
number of persons with disabilities.
6. Ministry of Education, Políticas de Integración para los Alumnos con Necesidades Educativas Especiales a la Modalidad Regular [Integración de Niños con Discapacidad a la Modalidad Regular [Integration of Children with Disabilities into Regular Schools], (Documento Trabajo, La Paz, 2002), 13.
7. Ley del 22 de enero de 1957 [Act passed on 12 January 1957], (certified copy provided by Norberto Vargas (Director of the General Archive of Bolivia's Presidency)), La Paz, 1986.
8. Ombudsman, Ley de la Persona con Discapacidad, 2nd ed. [People With Disabilities Act, Second Edition Chapter I, Definitions; sec. 1. B] (D.P., La Paz, 2002), 5.
Disability Population
In the last decade, three national surveys have attempted to measure the number of people with disabilities. There are concerns about the accuracy of the data resulting from all three.9
The first attempt by the National Institute of Statistics (INE) to quantify the number of people with disabilities in Bolivia took place in 1998. A question on disability was included in the National Demographics and Health Survey (ENDSA). The survey asked "do you have any severe physical impairments?" with answers including "deaf-mute, mental retardation, deaf, mute, blind, paralytic, crippled/one-armed."10 In the 13,136 households sampled, 461 persons with "severe physical impairments" were identified. Persons with disabilities were estimated to account for approximately 1% of the Bolivian population.11
As the result of advocacy efforts by disability organizations, the INE included an item on disability in the 2001 census. The census asked "In this household, how many people are... blind?/deaf-mute?/paralytic/and/or have had an arm or leg amputated?"13 There was no question designed to identify people with mental disabilities. Out of 1,977,665 households nationwide, 61,145 households reported persons with disabilities. The disability population identified by the census ranged from 0.9 to 1.2% of the total population.12
Most recently, the INE fielded a survey for the Improvement of Living
Conditions Program (2001 MECOVI) in October and November 2001. A total of
5,744 households were sampled. The survey asked "Do you have (...) any kind of
permanent disability?"14 Based on the results, the projected population of people
with disabilities in Bolivia is 87,293.15
9. Interview with the person in charge of the Program on Human Rights of People with Disabilities of the Ombudsman's Office, La Paz, 14 November 2003; interview with the Head of the Social Security Unit of the Disability Area of the Ministry of Health and Sports, La Paz, 12 September 2003.
10. National Institute of Statistics, Encuesta Nacional de Demografía y Salud [National Demographics and Health Survey], INE/ENDSA, La Paz, 1998, Household Questionnaire Appendix.
11. National Institute of Statistics, Encuesta Nacional de Demografía y Salud, 216-217.
12. National Institute of Statistics, Censo Nacional de Población y Vivienda de 2001 [National Population and Housing Census, 2001] INE, La Paz, 2002, 94-95.
13. National Institute of Statistics, Manual del Empadronador/a [Census Taker Manual] INE, La Paz, 2001, 56.
14. National Institute of Statistics, Encuesta de Hogares, Programa de Mejoramiento de Condiciones de Vida MECOVI-2001 [Household Survey, Improvement of Living Conditions Program, 2001 MECOVI ],INE, La Paz, 2001.
15. Ibid.
According to Clarita Franco de Machado and Rodrigo De Urioste, all INE surveys underestimate the rate of persons with moderate and mild disabilities. In the above surveys, only 11% of respondents with disabilities reported a mild disability, while slightly over half reported a serious or very serious degree of disability. Rates of moderate and mild disabilities are likely much higher than has yet been detected by the INE.16 Even though the last household survey moved away from a specific focus on severe disabilities, the continued focus on "permanent" disabilities and the overly vague question wording suggest serious validity problems for the current figures.
With no accurate source of national disability data, the population
estimates used in this report have been taken from the World Health Organization
(WHO), which estimates that an average of 10% of the world's population is
comprised of people with disabilities. At that rate, and with a total population in
Bolivia of 8,274,325 people, there would be approximately 827,432 people with
disabilities in the country.17
Legislation & Disability Rights
Legal Protections
The Bolivian government ratified the Inter-American Convention for the Elimination of All Forms of Discrimination Against Persons with Disabilities on 26 April 2002 and deposited the relevant instrument with the Secretary General of the Organization of American States (OAS) on 30 May 2003.18 Bolivia has also signed the Vocational Rehabilitation and Employment (Disabled Persons) Convention (No. 159) of the International Labor Organization. It was ratified by means of Law 1658, enacted on 2 August 1995.19
Additionally, the Bolivian government supports the creation of a United
Nations Convention on the Rights of the People with Disabilities. The Ministry
of Foreign Affairs endorsed the creation of a national Committee to Promote the
International Convention. At a working meeting held on 12 November 2003, a
ministry representative announced that the government supported the position
and proposed convention submitted by Mexico.20
16. Clarita Franco de Machado and Rodrigo De Urioste, Estudio sobre la Incorporación de Personas con Capacidades Diferentes al Sistema de Formación Técnica y Tecnológica [Research on the Inclusion of People with Different Abilities into Technical and Technological Training], (Corporación Calidad, La Paz, 2003), 94.
17. National Institute of Statistics, Censo Nacional de Población y Vivienda de 2001.
18. Law 2344 of 26 April 2002, (certified copy provided by Norberto Vargas).
19. Law 1658, National Committee of People with Disabilities, www.conalpedis.org.
20. Interview with the person in charge of the program on Human Rights of People with Disabilities of the Ombudsman's Office.
With regard to national legislation, the protection of individual rights in Bolivia is based on the Political Constitution. Although implicitly included, the Constitution does not specifically refer to the rights of people with disabilities. Section 6 states that "any human being has a legal personality and capacity according to law. Any human being enjoys the rights, freedoms and guarantees recognized by this Constitution, regardless of race, sex, language, religion, political or other opinion, origin, economic or social status or otherwise."21 The
only direct reference to people with disabilities is in section 158 of Title 2, which mandates that "the State shall assure continuing means of living and rehabilitation for invalids.22
Bolivia also has a disability-specific law. Law 1678 explicitly identifies people with disabilities as subjects of the rights set forth in the Political Constitution. Among the rights and benefits described by the act are education, employment, health care, rehabilitation, vocational training, and access to public spaces. All relevant public, private, and semi-public agencies must comply with the act. According to an official from the Ombudsman's office, this legislation "must be accompanied by the political and budgetary will and by a change in social behavior in society at large."23
Other laws also specifically mention people with disabilities. Children and youth with "physical, mental, psychiatric or sensory disabilities" are covered by the Child and Adolescent Code.24 People who are blind or visually impaired comprise one of the most well-established, active sectors of the disability community, with the largest organizational culture. Their advocacy efforts resulted in the creation of the Bolivian Institute for Blindness and established its goals and responsibilities.25
Sections of the Criminal Code create punitive consequences for crimes
committed against people with disabilities or those that concern injuries resulting in
disabilities. Thus, "individuals who commit a crime against a person with disabilities
[such as] rape, etc., may be sentenced... to a longer [imprisonment] period due to
the aggravating circumstances."26 The Act Against Family or Domestic Violence
sets out similar aggravated penalties when "the victim is disabled, older than sixty
years of age or is pregnant."27
21. Constitución Política del Estado, 3-4.
23. Ibid., 48
23. Ombudsman, Ley de la Persona con Discapacidad, 22-38.
24. Código del Niño, Niña y Adolescente [Child and Adolescent Code], La Tarjeta Jurídica, (Provin Servicios de Comunicación CD, La Paz, 2003), www.conalpedis.org.
25. Ley del 22 de enero 1957, (certified copy provided by Norberto Vargas).
26. Interview with the Executive Director of the National Committee of People with Disabilities, La Paz, 19 September 2003; Criminal Code La Tarjeta Jurídica, (Communication Services, La Paz, 2002).
27. Ley Contra la Violencia en la Familia o Domestica [Act Against Family or Domestic Violence], La Tarjeta Jurídica, (Provin Servicios de Comunicación CD, La Paz, 2002).
This penal framework is the primary mechanism for enforcement of disability rights. Law 1678 does not contain provisions for noncompliance. Thus, there has been little progress in the enforcement of rights granted by the Political Constitution and by Law 1678.28
The Ombudsman's Office is the most active entity that keeps records about death, abuse, violence, or discrimination against people with disabilities.29
However, several offices work to resolve specific violations. The Ombudsman safeguards the rights guaranteed by the Political Constitution and other laws. The head of the Ombudsman's Program on Human Rights of People with Disabilities is in charge of handling all disability cases.30 The National Committee of People with Disabilities (CONALPEDIS) works to enforce Law 1678. Its Board of Directors includes a National Secretariat specifically appointed to defend the rights of people with disabilities, pursuant to Section 3 of Regulatory Decree 24807 of Law 1678.31
In some cases CONALPEDIS tries to clarify alleged violations of disability rights with those who are involved. When that process fails to remedy an abuse, CONALPEDIS may resort to the Ombudsman, the Ministry of Labor, or other appropriate authorities.32 In one case, CONALPEDIS intervened when "a woman with disabilities was raped,...[and] the criminals tried to be released on parole."33
In response, CONALPEDIS worked to ensure that appropriate penalties were applied. The CONALPEDIS has also defended people with disabilities from guardians who have tried to violate their rights.
Overall, the Executive Director of CONALPEDIS reports that compliance
with current regulations is low. This situation is in part because of the limitations
of CONALPEDIS.34 Although there should be nine departmental committees in
addition to the national committee, only six have been created, and only four have
an annual budget. Even in those departments that have committees, many "do not
have legal counsels [or a] budget to help those people who need to seek assistance
from an attorney."35 The CONALPEDIS has an annual budget of 195,923 Bs
(US$25,779) for personnel and operating costs.36 The total amount allocated to
the departmental committees amounts to 373,023 Bs (US$49,082).37
28. Ombudsman, Ley de la Persona con Discapacidad, 40.
29. Interview with the Executive Director of the Bolivian Institute for Blindness, La Paz, 17 November 2003; Interview with the person in charge of the program on Human Rights of People with Disabilities of the Ombudsman's Office; Interview with the Executive Director of the National Committee of People with Disabilities.
30. Ley del Defensor del Pueblo [The Ombudsman Act], La Tarjeta Jurídica, (Communication Services, La Paz, 2002).
31. Ibid.
32. Director of the National Committee of People with Disabilities.
33. Interview with the Executive Director of the National Committee of People with Disabilities.
34. Ombudsman, Verificación Defensorial Comités Departamentales Personas con Discapacidad [Supervision of Departmental Disability Committees], (D.P., La Paz, 2002), 39-52.
35. Ibid.
36. Exchange rate applicable during this period of time: 7.60 Bs per 1 US Dollar.
37. Ombudsman, Verificación Defensorial Comités Departamentales Personas con Discapacidad.
Legal Barriers
Legal restrictions remain for some people with disabilities. The Civil Code
declares that "deaf-mute and mute persons are incapable of making a will."38 They
are likewise deemed "incapable" of serving as a witness as are people who are
deaf. Going further, some people with disabilities are labeled as having "absolute
incapacity" including persons who are "mentally deranged" or "blind and deaf."39
Civic Participation
Persons with disabilities have the right to elect and to be elected in both general and municipal elections. The Electoral Court has made an effort to allow people with visual disabilities to exercise their right to vote in general elections. At each polling station (typically located in schools), a "cercha" has been provided for people with visual disabilities to vote.40 In 2002, the Electoral Court arranged for the "cerchas" and trained its staff in the use of the ballots. No alternative format information is available for persons who are deaf.41
The only immediate provision for people with other disabilities is the
opportunity to vote without waiting in line.42 According the National Electoral Court,
voting places are generally located in the yard or ground floor. They estimate that
polling stations are 60 to 80% accessible.43 Conversely, CONALPEDIS reports
that "voting centers are often, if not always, full of barriers preventing people with
physical disabilities from reaching voting places."44
Inclusion
Communication
There is no Braille or audio-cassette version of the Political Constitution, nor are there any other Braille materials available in National Libraries. There is a plan underway at the Bolivian Institute for Blindness (IBC) to create a national Braille library. Today, Braille texts are only available at IBC special education centers.45 People who are blind or visually impaired must typically resort to having others read texts to them.
38. Ibid.
39. Justice and Criminal Matters of the Andean Jurist Committee, Código Civil y Procesal Civil.
40. Interview with a member of the National Electoral Court, La Paz, 17 September 2003. The "cercha" is a form including the initials of the political parties printed in Braille as well as the names of uninominal districts. It is an exact copy of the ballot paper. An "X" is marked next to a punched mark to cast the vote. It is edited in Bristol card material.
41. Interview with the person in charge of the program on Human Rights of People with Disabilities of the Ombudsman's Office.
42. Interview with a member of the National Electoral Court.
43. Ibid.
44. Interview with the Executive Director of the National Committee of People with Disabilities.
45. Interview with the Executive Director of the Bolivian Institute for Blindness.
National news broadcasts on both public and private television stations are not captioned for viewers who are hearing impaired.46 Televisión Boliviana, the official channel, has an agreement with the Bolivian Federation of the Deaf to implement sign-language interpretation in television news beginning in 2004.47
This project will be supported by Ministry of Education efforts to create Bolivian sign language and Braille alphabets.48
There are no methods or strategies in place for people with disabilities
to communicate with emergency centers in the event of a natural disaster or
criminal assault.
Education
The Ministry of Education's special education representative reports that no valid estimates of the number of school-aged children with disabilities are available from the INE.49 In Bolivia, 130 elementary schools integrate 478 children with special education needs.52 In 2002, an additional 7,390 students were enrolled in the special education system.53 According to the INE, the total population of school-aged children is 2,983,768. This includes both elementary and high-school aged children.50 Of those, 2,197,930, or about 74%, are actually enrolled in school.51 The number of school-aged children with disabilities could range anywhere from approximately 30,000 to near 300,000. Assuming even the lowest number, no more than 26% of children with disabilities are enrolled in the public educational system. Thus, somewhere between 74 to 97% of children with disabilities are excluded from Bolivian schools.
Considering the small number of students with disabilities who are
enrolled, special education and school integration programs are provided with
adequate infrastructure and human resources in all capital cities of the departments
countrywide. In addition, four departments have rural special education centers,
namely, Santa Cruz, Cochabamba, Tarija and Beni. 54
46. Interview with the Programming Director of Channel 7 of Televisión Boliviana (official channel), La Paz, 25 September 2003.
47. Ibid.
48. Interview with the National Coordinator of Special Education, La Paz, 24 November 2003.
49. Ibid.
50. National Institute of Statistics, Censo Nacional de Población y Vivienda de 2001, 9.
51. National Institute of Statistics, Anuario Estadístico 2002 [Statistical Annual Report 2002], (La Paz: INE-CD, 2003), 2-3.
52. Interview with the person in charge of the Team of Special Intercultural and Bilingual forms of Education, La Paz, 7 September 2003.
53. Interview with the National Coordinator of Special Education.
Decree 24807, which regulates the People with Disabilities Act, establishes that schools for people with disabilities must be physically accessible, and that appropriate communication, teacher training, and teaching materials should be available.55 These provisions are supplemented by municipal ordinances in the country's major cities. Legislation remains largely unenforced. New schools are few, and many refurbished schools have failed to remove steps or other barriers to free access. The compliance rate is estimated to be less than 20%.56
The Ministry of Education, in compliance with the Educational Reform Act, has been working with an educational resource center to verify that all educational materials are transcribed in Braille, and that the educational reform modules be sign-language interpreted with iconography to help reading by students who are deaf.57
The national teacher curriculum includes a six-month training course on integrated education that is required to obtain a degree in education.58 In addition, there is a two-year post-graduate distance learning program for special education teachers that includes materials developed by the Distance Learning National University of Spain (UNED). This program was proposed in 1998 and approved in 2001. The Episcopal Education Committee of the Bolivian Episcopal Conference and the Ministry of Education jointly run the program through FEDIA. While the program will be available to all teachers, priority will be given to the specialization of teachers who are currently working but who have no formal training. Persons with disabilities who wish to become teachers receive support.59
The Ministry of Education's National Bureau of Special Education is
implementing a "Parent School." Parents of children with disabilities meet regularly
at special education centers. One assistance center for children and youth with
mental disabilities, the Child Rehabilitation Institute (IDAI) under the departmental
government of La Paz, requires parents with children at the center to attend special
courses where they learn to better assist their children. The Bolivian Institute for
Blindness (IBC) is also trying to involve the parents and siblings of children who
are blind in the educational process by learning how to read and write in Braille
and assisting blind children who do not attend a special school.60
55. Ombudsman, Ley de la Persona con Discapacidad, 25.
56. Interview with the Executive Director of the National Committee of People with Disabilities.
57. Interview with the National Coordinator of Special Education.
58. Interview with the person in charge of the Team of Special Intercultural and Bilingual forms of Education.
59. Interview with the National Coordinator of Special Education.
60. Interview with the Executive of the Bolivian Institute for Blindness.
No effective official disability detection program is currently available. Although some programs exist, most disabilities are detected at a later stage.61
A Community-Based Rehabilitation pilot program run by CONALPEDIS is funded by the Pan American Health Organization and the WHO. Currently, the program is concentrated in three cities: El Alto, Tarija, and Cochabamba.62 As part of the program, the departmental committees provide Disability Detection cards, which offer information on screening children for visual, hearing and mental disabilities.63
Additional programs include a Ministry of Health initiative to test reflexes of children aged under age 4, and the White Tent program. Under that program, a white tent is erected in a small town square for a week, and health workers gather information on the general nutrition level of the community that can then be used for disability detection and prevention.64
Education and training opportunities for older adolescents and young
adults with disabilities are scarce.65 Only 30% of the 90 special education
centers across the country offer occupational training and employment services.
The departments of Pando and Beni have no such services.66 The Ministry of
Education has plans to establish an office within the framework of Technical and
Technological Education that will address the issue of vocational training.67
61. Interview with the person in charge of the program on Human Rights of People with Disabilities of the Ombudsman's Office.
62. Interview with the Executive Director of the National Committee of People with Disabilities.
63. Interview with the person in charge of the Team of Special Intercultural and Bilingual forms of Education.
64. Interview with the National Coordinator of Special Education.
65. Interview with the Executive Director of the National Committee of People with Disabilities.
66. Interview with the National Coordinator of Special Education.
67. Clarita Franco de Machado and Rodrigo De Urioste.
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Employment
The largest sector of the labor market (36.55%) is informal employment, characterized by self-employment and consisting of micro-businesses, small business, and small farms.68 The nature of these jobs makes it difficult for the Industry Chamber and the Ministry of Labor to obtain statistical data or employment records for many workers, including substantial numbers of people with disabilities. However, the unemployment rate for people with disabilities as estimated by disability organizations ranges from 60% to 85%.69 The major
barriers to employment are lack of jobs, lack of technical or vocational training for persons with disabilities, and discrimination.70
Although there are general employment protections for people with disabilities, they remain unenforced. The Ministry of Labor and the National Committee of People with Disabilities are working on a preliminary Labor Act for people with disabilities.71 The draft is under review by disability organizations, the government, and the private sector.
None of the major industries currently have explicit labor policies encouraging the employment of persons with disabilities and prohibiting discrimination. Some government agencies have offered a limited number of employment opportunities to people with disabilities. This achievement was the result of advocacy efforts on the part of departmental disability committees and disability organizations, including the Bolivian Disability Confederation (COBOPDI) and the Bolivian National Federation for the Blind (FENACIEBO). Employment of people with disabilities is also regulated by municipal ordinances in force in the major municipalities of the country and by some Departmental Resolutions. For example, in the municipality of La Paz, 1% of its administrative staff is made up of people with disabilities. In the City of El Alto, 3.5% of positions should be filled by people with disabilities, although the actual percentage is likely somewhat lower.72
The INFOCAL Foundation, a project run by the Bolivian Private
Entrepreneur Association, provides training in various types of skilled labor.
Although the foundation does not specifically focus on people with disabilities,
the courses are open to persons with disabilities who wish to be included. The
program is focused in the country's major cities, with particular significance in
Oruro, Cochabamba, Santa Cruz, Tarija, El Alto, and La Paz.
68. National Institute of Statistics, Anuario Estadístico 2002, 7-10.
69. Interview with the Executive Director of the National Committee of People with Disabilities and Interview with the Executive Director of the Bolivian Institute for Blindness.
70. Interview with the Executive Director of the National Committee of People with Disabilities; Panel discussion with leaders of disabilities organizations, facilitated by author, La Paz, 29 September 2003.
71. Interview with the General Director of Industrial Safety of the Ministry of Labor and Delegate to the National Committee of People with Disabilities, La Paz, 23 September 2003.
72. Interview with the Executive Director of the National Committee of People with Disabilities.
Training programs include: computing, mechanics, baking, electricity, gas
installation, sewing and dressmaking, pattern designing for sports uniforms, fabric
painting, and accounting, among others. Upon the completion of training courses,
INFOCAL attempts to place workers with private businesses. Unfortunately, very
few persons with disabilities have attended INFOCAL courses.73
Health Services
In Bolivia, access to health insurance and medical assistance is often inadequate for people with disabilities. A National Disability Register project by the Ministry of Health is currently working to determine how many persons with disabilities need medical insurance and to identify funding sources.74 The Social
Security Code provides protection for people who have acquired a disability in the course of employment.75 People with visual impairments are covered by the short-term insurance and health care system of the Bolivian Institute for Blindness, which offers comprehensive short-term medical insurance covering people who are blind. Funds are provided to the Institute by the National General Treasury (TGN) and 5% of these funds are annually allocated to short-term insurance.76
The government does not generally allocate financial resources for providing health services to people with disabilities.77 The Rehabilitation Bureau of the Ministry of Health was closed in 1994, but efforts are underway to reopen the bureau.78 For people who have health insurance and have acquired a disability in an accident, some resources are available through the National Health Fund's National Rehabilitation center in La Paz. The center provides reconstructive medicine and rehabilitation services. Financial support has been restricted to physical rehabilitation.79 Rehabilitation services funded by the public and semi-public organizations are available in the major cities, namely, La Paz, El Alto, Santa Cruz, Sucre, and Cochabamba.80
Technical aids for disability rehabilitation are state-funded.81 Some
private organizations provide orthopedic instruments to people with disabilities.
The Association for the Rehabilitation of Blind and Visually Impaired Persons
(APRECIA) in Santa Cruz provides important technological resources to people
who are blind.
73. Ibid.
74. Interview with the Head of Social Security Unit of the Disability Area of the Ministry of Health, La Paz, 12 September 2003.
75. Interview with Social Security Director of the Ministry of Health and Sports, La Paz, 28 November 2003.
76. Interview with the Executive Director of the Bolivian Institute for Blindness.
77. Ibid.
78. Interview with the Executive Director of the National Committee of People with Disabilities.
79, Ibid.
80. Mirjam Guevara, Ofertas Educativas para Personas con Necesidades Educativas Especiales en Bolivia [Educational Offers for People with Special Education Needs in Bolivia], (UNESCO, UNICEF and German Adult Education Association, La Paz, 1997), 14-15.
81. Interview with the Social Security Director of the Ministry of Health and Sports.
In La Paz, an organization called the Wheelchair Bank (BANDESIR) lends wheelchairs to low-income people, and RTP (Popular Radio Television) develops fund-raising campaigns to help people in need who require wheelchairs, other orthopedic devices, or specialized rehabilitation treatments.82 The Rotary Cub, the Lions Club, and Caballeros de Malta are also involved in these campaigns to provide assistive technology.83 In addition, CONALPEDIS and the Cabinet of the First Lady solicit foreign donations for some technical aids.84
According to the Ministry of Health, there is no specific training available to medical students in the provision of care to people with disabilities. Medical professionals acquire basic knowledge on the provision of services to people with disabilities during their general courses or during special courses in traumatology, ophthalmology, and otorhinolaryngology.85 Medical residencies are available in some specialized subjects including occupational therapy, physical therapy, physiatry, and prosthetics and orthotics.86
Although such specialized training on the provision of care to people with disabilities is accessible to all physicians, actual interest and participation is low. The Ministry of Health reports that 2% of primary care physicians, 4% of pediatricians, and 1% of medical assistants attend such courses. There are 12 rehabilitation specialists in Bolivia with a professional degree. In addition, there are about 70 self-trained rehabilitation physicians.87
The Ministry of Health has not yet implemented a community-based rehabilitation strategy; however, plans are scheduled to begin doing so in 2004.88
A pilot program including the early detection initiatives has been underway since
1999. Work has focused in Cochabamba department, in marginalized areas and
rural municipalities of La Paz, and in the department of Tarija. Executive directors
of all Departmental Committees were provided training on community-based
rehabilitation to facilitate the introduction of the CBR program.89
Housing
Leaders of disability organizations estimate that close to 90% of people with disabilities live with their families while most others reside in institutions.90
There are no independent living centers in Bolivia.91
82. Panel discussion.
83. Interview with the Executive Director of the National Committee of People with Disabilities.
84. Ibid.
85. Interview with the Social Security Director of the Ministry of Health and Sports.
86. Interview with the Executive Director of the National Committee of People with Disabilities.
87. Interview with the Social Security Director of the Ministry of Health and Sports.
88. Ibid.
89. Ibid.
90. Ibid.
91. Interview with the Executive Director of the National Committee of People with Disabilities.
People with disabilities are not eligible for public housing, and there are
currently no subsidies or support for buying or building a house.92 The Vice-Ministry of Housing is developing regulations regarding the accessibility of housing
units for people with disabilities. The regulations establish a preferential scoring
for people with disabilities, so that any person having some kind of disability will
have priority access to housing programs.93 This work is jointly coordinated by the
CONALPEDIS, IBC and the Vice-Minister of Housing. The Ombudsman has been
monitoring the progress of this program.94
Institutionalization
There are around a dozen institutions in Bolivia operating with exclusive
mission of providing long-term housing and care to people with disabilities.
Combined they accommodate about 400 people. The institutions are listed in
table one.95
Table 1: Long-term institutions for people with disabilities in Bolivia
| Facility | # of Residents | Population served | Location |
| Villa Victoria Home | 30 | Women w/ mental disabilities | La Paz |
| Eric Boulter Special Education Institute | 27 | People w/ hearing disabilities | La Paz |
| Child Adaptation Departmental Institute | 70 | People w/ mental disabilities | La Paz |
| Child Rehabilitation Institute | 25 | Children w/ physical disabilities | La Paz |
| Calcutta's Sisters Home | 60 | People w/ disabilities | El Alto |
| Luis Braille and Santa Cecilia School | 30 | People w/ visual disabilities | La Paz |
| Wenceslao Alba | 20 | People w/ visual disabilities | Potosi |
| Manuela Gandarillas School | 20 | People w/ visual disabilities | Cochabamba |
| Maria Antonieta Suárez | 20 | People w/ disabilities | Oruro |
| Aprecia Sucre | 8 | People w/ disabilities | Sucre |
| Bolivian Society of Psychiatry | 40 | People w/ psychiatric disabilities | Sucre |
| Gregorio Pacheco Hospital | 40 | People w/ psychiatric disabilities | Sucre |
92. Interview with the Director of Housing Policies of the Vice-Ministry of Urban Development and Housing, La Paz, 4 November 2003.
93. Ibid.
94. Interview with the person in charge of the program on Human Rights of People with Disabilities of the Ombudsman's Office.
95. Interview with the Executive Director of the National Committee of People with Disabilities and Interview with the Executive Director of the Bolivian Institute for Blindness.
These centers offer psychological counseling, psychiatric counseling, rehabilitation services, intensive-care services and education/training.96
People living in these institutions are often unaware that they have the right to refuse treatments. The CONALPEDIS reports that "treatment and institutionalization of persons with disabilities [are] generally decided against their will." Children are often institutionalized after having been abandoned or at the request of their families. Although many of the homes "are intended for a certain age group...[most] centers cover a wide variety of ages" because institutions for adults are largely absent.97
One exception to generally poor conditions found in institutions are the
educational centers of the Bolivian Institute for Blindness. These centers will not
accept residents against their will. They focus on education and are sometimes
able to integrate students into the mainstream school system.98
Accessibility
The Regulatory Decree of Law 1678 and various municipal ordinances establish that new buildings and facilities must be accessible to people with disabilities, and all architectural barriers must be removed.99 Existing buildings and facilities should also be remodeled to make them accessible. The overall level of compliance with these regulations is low. In the La Paz, the country's capital city, post offices are not accessible to wheelchair users.100 Only three buildings
in the capital have elevators with Braille numbers; none is equipped with a sound system.101 It is estimated that only 1% of public buildings in the city are accessible to people with disabilities, although there are some notable exceptions.102 Some
public buildings such as supermarkets are being adapted by the addition of entrance ramps. Major squares and streets of all departmental capital cities also have ramps. These accessibility measures are not comprehensive, however, because intersections do not have adequate signaling.103
No courses on universal design are regularly available to architects in
Bolivia. The Bolivian Institute of Standards and Quality (IBNORCA) offered a
course on standardization and quality in August 2003. They reported that the
course was poorly attended, with only five or six architects enrolled.104
96. Ibid.
97. Interview with the person in charge of the program on Human Rights of People with Disabilities of the Ombudsman's Office.
98. Interview with the Executive Director of the Bolivian Institute for Blindness.
99. Ombudsman, Ley de la Persona con Discapacidad, 33.
100. Ibid.
101. Interview with the Executive Director of the Bolivian Institute for Blindness.
102. Interview with the Executive Director of the National Committee of People with Disabilities.
103. Interview with the Director of Housing Policies of the Vice-Ministry of Urban Development and Housing.
104. Interview with a Standardization Expert of the Bolivian Institute of Standardization and Quality (IBNORCA), La Paz, 6 November 2003.
Rural, urban, and interdepartmental transportation services are currently not accessible to wheelchair users, and no adapted or special transportation is available. People with disabilities must resort to costly taxis or their own private means of transportation, if they are financially able to do so.
The Vice-Ministry of Public Transportation is currently drafting National
Transportation Regulations. Some provisions are aimed at ensuring that
interdepartmental transportation vehicles have special seats reserved for persons
with disabilities, areas to place devices used by people with disabilities, direction
signaling, and vehicles with suitable external and internal access.105
Disability Action & Awareness
The National Committee of People with Disabilities (CONALPEDIS), created by Law 1678, is the official agency coordinating disability policy in Bolivia. It was designated an independent agency of the former Ministry of Human Development, but it is not associated with the Ministry of Health and Sports. The main purpose of CONALPEDIS is to coordinate, control, and advise on disability policies and actions.106 It is composed of officials from government ministries and representatives of both governmental and non-governmental disability organizations. Half of the members of the National Committee of People with Disabilities are people with disabilities.107
Current CONALPEDIS activities are not based on any long-term national plan. Instead, its work is based on an Annual Operating Plan (POA). Departmental Committee activities are organized in a like manner. Each committee performs its own activities as established in its respective POA, with no centralization or general direction. In an effort to remedy this lack of a national disability action plan, the CONALPEDIS has begun coordinating national meetings bringing together various agencies responsible for enforcing Law 1678.108
Disability units have recently been established in the City Hall of La Paz and the city of Caranavi, a medium-sized city in the La Paz Department.109
Cochabamba's and Oruro's departmental governments also have Disability Units
reporting to the Social Management Bureau.110
105. General Director of Ground Transportation of the Vice-Ministry of Transportation, La Paz, 26 de September 2003.
106. Ombudsman, Ley de la Persona con Discapacidad, 11.
107. Ibid., 11-16.
108. Ombudsman, Verificación Defensorial Comités Departamentales Personas con Discapacidad, 39-52.
109. Interview with the Executive Director of the National Committee of People with Disabilities.
110. Interview with the person in charge of the program on Human Rights of People with Disabilities of the Ombudsman's Office.
Bolivia has one cross-disability organization, the Bolivian Confederation of Persons with Disabilities (COBOPDI), which was established in 1989.111 Its
affiliate members are: the Bolivian Federation of the Blind (FEBOS); the Bolivian Association of Integrated Sports (ASODEIN); the Bolivian Association of Parents and Friends of Persons with Mental Disabilities (ABOPANE); and the Christian Fraternity of Ill and Disabled Persons (FCPEDB). Another important disability organization is the Bolivian National Federation for the Blind (FENACIEBO), which founded the Bolivian Confederation of Persons with Disabilities.112 National and departmental congresses are held every two years to help coordinate the activities of these organizations. Organizations of people with visual impairments are not involved in these coordinated efforts, but in some departments their members participate in activities of the COBOPDI.113
In general, funding of disability organizations is largely derived from fund-raising efforts and contributions made by their own leaders. Members of these institutions can very seldom make financial contributions.114 The government provides a small amount of financial support to some organizations including the Bolivian National Federation for the Blind and the Bolivian Association of Integrated Sports.115
In the past, the Christian Fraternity of Ill and Disabled Persons obtained financial support from international cooperation organizations of the Catholic Church.116
Broadly speaking, ongoing courses about disability polices, the rights of persons with disabilities, inclusive education, and other disability-related subjects are not sponsored by universities or advanced education institutions. Two pilot programs are worthy of mention. First, the Disability Advanced course was sponsored by the Association of Comprehensive Community Rehabilitation (CCR), through the University of San Simón in Cochabamba and the Technical University of Oruro (UTO). It was available in the city of Oruro from 1999 to 2001.117 Second, the Advanced Distance Learning Course was sponsored by CONALPEDIS and the Fund for Strengthening Civil Society Organizations (FOSC) in 2003.118
The Ombudsman's Office representative stated that "disability is still a
concealed issue" in Bolivia. With regard to strategies for improving the state of
disability rights, the office suggested that "it is important to disseminate information
about disability issues and to raise awareness on the major obstacles people with
disabilities encounter as a strategy for the gradual enforcement of legislation...it is
important to achieve a change in social behavior, to raise awareness among the
authorities as well as in society at large."119
111. Departmental Government of La Paz, Testimonio Notariado [Notarial Certificate], Government Notary's Office, La Paz, 1996.
112. Interview with the Executive Director of the Bolivian Institute for Blindness.
113. Departmental Government of La Paz, Testimonio Notariado.
114. Panel discussion and Interview with the Executive Director of the National Committee of People with Disabilities.
115. Interview with the Executive Director of the National Committee of People with Disabilities.
116. Ibid.
117. Interview with the National Coordinator of the Association of Integral Rehabilitation in the Community, Cochabamba, 29 August 2003.
118. National Committee of the People with Disability, Cursos [Courses], La Paz) www.conalpedis. org.
119. Ibid.