Teerawat Sripathomsawad

Teerawat Sripathomsawad is reforming disability care in Thailand from a centralized medical model to one founded on personal care and independent living. Weaving together peer counseling, services at the neighborhood level, and access to personal assistants, Teerawat helps the disabled gain control over their own destinies.

Teerawat has introduced the practice of independent living (IL) at the community level in Thailand to ensure the disabled get the care they need with the greatest access for immobilized citizens. He establishes neighborhood centers where all disabled persons, regardless of age, type or extent of disability, can learn to judge their capacities, link into vocational training, motivate each other to keep moving forward, and stay independent from institutionalization. Together they are better able to push for their social, economic, and political rights, and take an active role in society. At the policy level, Teerawat focuses on enforcing the 1997 Constitution clauses regarding the disabled and reallocating government appropriations to a decentralized community-based approach. Core to his strategy, Teerawat specifically works to redirect funding from bureaucratic state services to personal assistants and mentors for each severely disabled person. Combining his credibility as a quadriplegic with his long-time expertise as a change agent, Teerawat is legitimizing independent living for the disabled across Thai society.

More than 60 percent of the world’s disabled live in the Asia Pacific region. While the independent living concept has gained adherents in countries such as Germany, Japan, and Australia, it is seen as unattainable for Thailand and other developing countries, where disability is strongly associated with poverty, illiteracy, and endemic poor health. Compounding the problem in Thailand is a strongly held belief that the genesis of disability stems from bad deeds in the past—negative karma. This further isolates the disabled by making them feel guilty for their infirmity and undeserving to participate in society.
The government has made efforts to improve the lives of its disabled citizens. For example, though far from sufficient, families of the disabled are eligible to receive 500 baht (US$15) a month. Mandated by the Ministry of Human Development and Social Security, this stipend is distributed only to disabled citizens who are registered through the national census. Due to social attitudes, however, only a fraction of the disabled have been officially counted. The government has also invested large sums to construct urban centers for disabled persons, but these segregated institutions, oriented to medical service provision and vocational training for menial jobs, are physically beyond the reach of most disabled people, and ultimately perpetuate dependence and low economic status. 
A societal norm makes the situation even more complex. In Thailand, independence from one’s family is not viewed positively as it is in other countries. Families often do not understand why a disabled member of the family would choose to live on his/her own or make his/her own life decisions. Any child, disabled or without disabilities, is educated and trained to be a contributing member of the family rather than to manage her/his household alone. And since disability is linked to karma for wrongdoings of the past, Thailand’s disabled are particularly marginalized and often hidden away. Strengthened by the attitude that disabled individuals could never care for themselves or plan their own lives, most see no purpose in counting them in the national census.
Most of the disabled in Thailand are very poor and have difficulty accessing social services. Often they are not aware of services such as healthcare, education, vocational training, and employment designated for the disabled or may live in rural areas where these services do not exist. For those living in urban areas, access to infrastructure such as buildings and public or private transportation is almost nonexistent. Therefore, the challenges to implement the concept of independent living in Thailand are many, beginning with changing the mind-set of the disabled themselves and moving to the family, the community, and the government. At the personal level, the disabled must have the knowledge, will, and confidence to take responsibility for themselves. They need to believe they can contribute to their families and society.
Given the obstacles to set up community-based Independent Living Centers in Thailand, there have only been three related attempts. Two include a Christian church-run center in Chonburi province and an association in Nonthaburi, and both consider IL a minor service for the disabled rather than as a program with invaluable possibilities. The third program is Teerawat’s organization in Nakhom Pathom that focuses on IL at both the community and national levels.

Teerawat’s IL model is encouraging disabled persons to exercise control over their lives through a variety of self-help and empowerment activities. IL is defined as the right of all persons, regardless of age, type, or extent of disability, to live in the community, as opposed to living in an institution; to have the same range of choices as everyone else in housing, transportation, education, and employment; to participate in the social, economic, and political life of their communities; to have a family; to live as responsible, respected members of their communities, with all the duties and privileges that entails; and to unfold their potential. Today expanding across four provinces in Thailand, Teerawat’s model works by creating partnerships among and between the disabled, the society, and the government.
Teerawat focuses on increasing the capacity of the disabled to live quality lives with the help of personal assistants, group support through peer counseling, and greater physical mobility in public spaces. The Nakhom Pathom Independent Living Center was officially launched in 2005 and reaches 3,800 disabled persons. It is led by key severely disabled leaders. The ILC facilitates the participation of the disabled in decision-making processes including the selection and organization of services for disabled persons by disabled persons. It also provides information and referral services as well as skills development training, and advocates for the protection of the rights of people with disabilities. With a strong emphasis on peer counseling and a keen understanding of the problems, challenges, and dreams of his peers, Teerawat has involved the disabled, the local administration, and communities, to launch a public campaign to facilitate physical access for the disabled and to ensure the construction of buildings and passageways conform to their needs.
At the national and policy levels, Teerawat works with government ministries to ensure that every disabled person is registered in the national census, to increase public awareness of the rights of the disabled, and to make facilities accessible. Finally, and critical to his model, Teerawat has advocated for financial support that would pay for personal assistants for all severely disabled citizens. A redistribution of government funds to more specialized personal care would equate to a state acknowledgement of the failures of the current national system and legitimize the value of Teerawat’s independent living centers.
As an active disabled leader, Teerawat is a powerful role model for others. He began his work with the Department of Social Development and Welfare of Nakhom Pathom (1995) to gain access to the database of all disabled persons living in the area. After attempting to reach the disabled in seven districts of Nakhom Pathom with letters, phone calls, and house visits, Teerawat launched a “Mobile Registration Unit” to encourage them to register. Through this one-stop local outreach program, the disabled learn about their rights via a booklet provided by Teerawat’s club and gain access to resources (the Department of Social Welfare, the Red Cross, the Office of the Governor and the Department of Public Health, etc). Teerawat then initiated a program whereby teachers from non-formal education centers and vocational training centers visited the homes of the severely disabled to provide them with educational skills. Prior to this initiative, the disabled received education only when attending schools for the blind or the deaf. With support and recognition from the Ministry of Education and the Nakhom Pathom Chairperson of the Non-Formal Education Department, the program brought teachers into the homes of the disabled for the first time.
Despite the 1991 Rehabilitation of Disabled Persons Act and ministerial regulations, many restrictions and prohibitions remain for persons with disabilities. Teerawat and Ashoka Fellow Narong Patibatsarakich worked to include significant reforms in the 1997 Constitution. Their campaign: “The Disabled Also Know How To Vote” helped raise public awareness of the rights of disabled persons and pressured the government to include Articles specifically about disability rights. One such article—Article 80—emphasized that the state shall ensure a good quality of life for persons with disabilities and improve their ability to depend on themselves for health protection and quality of life—a legal step towards the implementation of the IL concept.
Rooted in the belief that the disabled can and must take charge of their lives, supported by the 1997 Constitution and other legal standards, and encouraged by his peers, in 2002 Teerawat began work on the Nakhom Pathom Independent Living Center in collaboration with two disability centers in neighboring provinces. The three-year pilot project received local and international financial support from the Japanese International Cooperation Agency, the Thailand Department of Social Development and Welfare and the Thai Health Promotion Foundation. At the pilot stage, twenty participants recruited from Nakhom Pathom province attended a three-month training during which they collected information from families on the lifestyles and needs of the disabled, participated in exposure trips, discussed life goals and aspirations, drafted a customized program (including peer counseling, future plans based on their respective capabilities, and vocational trainings) devised by the disabled for the disabled, and sought personal assistants within their communities. With ten participants completing the training and ten participants dropping out due to complications with their health and disabilities, Teerawat saw a tremendous need to focus part of his program on building the emotional development and self-confidence of the disabled. Peer counselors and personal assistants became central to his idea.
Teerawat estimates that within the next ten years, the IL model will have spread across Thailand. To hasten this expansion, his network will partner with Ashoka Fellow Narong Patibatsarakich’s, Thai with Disability Foundation (TDF), collectively advocating for policy change and playing a leading role in furthering and strengthening the network of the disabled in Thailand.

The middle child among five siblings, Teerawat was one of the three children his parents could afford to send to school. After completing high school in Bangkok, he enrolled in the Physical Education department at Chulalongkorn University School of Education (1978). Simultaneously, many students who had fled urban areas to join the pro-democracy student movement were returning to university so he was exposed to many social activists, their idealism, and determination to democratize Thailand. Teerawat learned from his seniors and began to participate in a wide range of student activities, especially influenced by his roommate Ashoka Fellow Wallop Tangkanurak, Ashoka’s first Thai Fellow. Wallop strongly encouraged Teerawat to run for student elections and during his second year he was elected President of the Athletics Association and served on the Student Union. A rugby star and leader of the powerful Student Union, Teerawat promoted student engagement and activism in social development, and orchestrated and played in intercollegial games to bring students and alumni together.
It was during a game against the professional Marines team that Teerawat lost his balance and was crushed by teammates. The accident severed his spinal cord. Spending the next six months in a hospital room, he became despondent and depressed. The university said of course he could return to school once he stabilized. But it took him two years just to be able to sit up. And the university was not built for disability access. He then became aware that a friend had suffered injuries in a motorcycle accident. They shared their fears, questioned their capacity to re-enter society, and found immense strength through supporting each other. In 1981, having found the physical and mental strength to cope with his situation, he joined the Siam Rat Newspaper and partnered with the Editor to produce articles on the rights of and legal protections guaranteed for the disabled. In 1989, Teerawat campaigned alongside Ashoka Fellow Narong Patibatsarakich to draft and promulgate legal standards for the disabled in the areas of education, vocational training, and social life. In 1993, two years after the enactment of these laws, Teerawat attended a capacity-building program organized by the TDF that planned outreach and centers for the disabled in other parts of Thailand beyond Bangkok. Conscious of the macro-level approach (policies, laws, accessibility) and necessity of TDF’s work, Teerawat saw the necessity for a complementary approach that would begin at the neighborhood level with the disabled themselves.