PRA by disabled people: experience from rural Cambodia

A Cambodian NGO recently piloted a project in which disabled people controlled a participatory community assessment (PRA), in a country where disabled voices are rarely heard. Steve Harknett describes the project's challenges and successes.

Disabled people are among the most marginalised, voiceless people in any society, but particularly so in Cambodia. Unlike many developing countries, the Cambodian disability sector is still dominated by organisations for rather than of disabled people. The national disability rights movement is in its infancy and no disability legislation has been passed. Disabled people are traditionally seen as passive receivers of aid, a belief which persists among many NGOs, which plan and design disability programmes with little input from disabled people themselves.

This is a problem that has been recognised by Disability Development Services Pursat (DDSP), which runs a community-based rehabilitation (CBR) project. In the past DDSP has carried out village-level participatory rural appraisals (PRAs) which were designed and implemented by its staff and local government officials, with disabled people's role limited to consultation. Although the PRAs succeeded in getting disabled people's input into the CBR project design, they did not empower disabled people as they were still the objects of the research rather than participants or leaders of it.

Disabled people at the project helm

In response to this, DDSP embarked upon a new PRA research project in February 2005, supported by the Disability KaR Programme. The project aimed to pilot a participatory community assessment controlled by disabled people themselves. This, it was hoped, would build disabled people's capacity in community development skills, challenge community attitudes towards them, and promote their participation within DDSP.

The project involved training the team in PRA methods so they could plan fieldwork (e.g. make decisions about research topics and tools) and carry out short PRA exercises in three villages. After each village PRA, the team also analysed and presented the results, and evaluated the process. Lessons drawn from the project are discussed below.

Training inexperienced disabled people

During the three-day PRA training, the team learnt about several PRA tools and made a plan for using them in the field. The following points contributed to the success of the training workshop:

Focus on confidence-building. The very term 'training' can be threatening to uneducated people who imagine it as formal learning using literacy skills which they do not have. The training was therefore termed a 'meeting' and other alien terminology such as PRA was avoided. Other steps taken to build participants' confidence were: keeping the training group small to reduce shyness; starting the training with a simple, fun activity like 'picture introductions' (participants drawing pictures and using them to talk about their lives); being realistic in what the participants could learn - PRA tools needing advanced literacy, group facilitation or presentation skills were avoided; creating a comfortable environment - e.g. participants and facilitators sat on the floor in the traditional Cambodian way, in a private house rather than an office.

Awareness by the facilitator of the participants' level and use of appropriate communication methods. Verbal and pictorial, rather than written, methods were used, with frequent reviews and repetition, at a pace consistent with that of the participants' learning.

Consideration of physical accessibility and personal needs.

Not assuming that the disabled people automatically had solidarity with one another or had comprehensive knowledge of all types of disability. The training included sessions on types of disability and respect for and understanding of all disabled people. Emphasis was put on including marginalised groups such as people with visual, hearing and learning difficulties, people with mental health problems, disabled women, children and elderly people.

Including participatory monitoring of the training throughout, and acting on any problems/ideas raised by the participants.

Appropriate PRA tools

The PRAs used many ways to collect information about disabled people in the community. Due to lack of experience, low educational level and the short time allowed for training, the disabled team members found some tools easier to use than others. Those they found easy to use were:

• Pictorial methods - e.g. an illustrated household wealth surveying tool was developed and used to compare the wealth (measured by ownership of cows, pigs, TV, etc.) of households with and without a disabled person. Pictures were also used in PRA presentations, e.g. illustrated graphs showing prevalence of types of disability. Illiterate people can understand pictures more easily than words, although producing the pictures was difficult - people who are illiterate do not generally have experience in drawing, so time was needed for the team to practice, in order to produce sufficiently useful pictures.
• Activities directly and concretely related to their daily lives, e.g. ranking disabled people's income-generating activities and discussing their daily activities.

The tools the team found difficult included:

• Activities involving advanced facilitation skills. One exercise involved developing solutions to disabled people's problems. Villagers typically responded with a list of things they wanted NGOs to give them, and facilitation was needed to get the villagers to think of ways in which the community could help themselves. The disabled team members, sharing the same mind-set as the villagers, were unable to do this.
• Activities involving literacy and numeracy skills, e.g. using written questionnaires and calculating percentages from wealth-ranking data." Role-play - the team-members were unfamiliar with this and felt embarrassed.
• Talking to people in authority in the community, e.g. teachers and village chiefs, as they did not have experience in this and felt inhibited.

Enabling all disabled people to participate

In the field, the team were constantly reminded to try to include all disabled people in PRA activities and to overcome barriers to their participation - both physically attending the meeting and also joining in actively.

Examples of good practice included:

• Seating team members among participants in meetings and giving additional encouragement or explanation when they observed that this was needed.
• Helping people with hearing impairments, e.g. by asking family members to communicate with gestures, and inviting people to sit at the front so they could hear more easily or lip-read.
• Using simple language and repeating verbal instructions. The facilitator asked the participants questions to check their understanding.
• Keeping written exercises to a minimum because of low literacy. Where written flipcharts were used, only short key-points were written, using large, clear letters, and they were accompanied with clear verbal explanations.
• Visiting disabled people absent from meetings or who sent a family member to attend on their behalf (which is common practice in Cambodia) at their home. Sometimes they were absent for good reasons, but often it was due to not receiving the information (perhaps due to marginalisation in the village), transport problems or behavioural problems, which the PRA team could help address.
• Acting on information: e.g. one village chief said he had heard of a man with severe moving difficulties living far away, but had never met him. The team, after a lengthy search, tracked him down and brought him to a meeting by motorbike. Many villagers had never seen him before. In another village the aunt and uncle of a severely disabled orphan - who were very unmotivated and neglected the child as he is not their own - were given encouragement and help with transport to come to the meeting.

Impact of the project

The research project was pioneering in Cambodia as it put rural, inexperienced, disabled people right at the centre of the development process. The project had an impact on the disabled PRA team members themselves, their communities, DDSP and the disability sector in Cambodia in general, as described below.

Disabled team members: the five disabled people gained skills, experience and increased confidence in doing PRA community assessment. They also learnt about different types of disability, and gained a wider understanding of different disabled people's situations.

Their communities: villagers were able to see disabled people playing an important role in community development. There was some surprise among villagers that the woman with learning difficulties was playing such a role, and among her family, who had formerly considered her as quite useless.

DDSP: the project contributed to a change in attitude among DDSP staff as disabled people were doing a task that was normally theirs. It was the first time that DDSP staff had worked alongside their beneficiaries and it challenged the traditional NGO-client relationship. It is hoped that in future PRAs, DDSP will include representation from disabled people.

Disability sector: the research project involved two other NGOs in Cambodia, Handicap International Belgium and Landmine Disability Support, who, like DDSP, were experiencing difficulties in including rural disabled people in community surveying and project designing.

Results from this research project will be shared with these NGOs and the rest of the disability sector in Cambodia. It is hoped that this will encourage changes in practice, increasing disabled people's participation in and control of development processes such as community assessment and project design, to ensure that projects more fully meet their needs.

Steve Harknett is Advisor to Disability Development Services Pursat (DDSP), a Cambodian NGO that supports a wide range of initiatives for and with disabled people. For more information, contact Steve Harknett or Keo Sophat at ddsp@cambodiacic.org, PO Box 9206, Pursat, Cambodia