In Laos, the poverty rate dropped by more than half between 1993 and 2019. However, 18% of the population still lives below the poverty line. Notably, in the most impoverished neighborhoods of Laos, the prevalence of people with disabilities is higher.

More than 160,000 people are living with a disability in Laos, accounting for 2.8% of the total population. As with other developing countries, the primary causes of disability in Laos are illness, accident and congenital defects. However, one can additionally attribute disabilities in Laos to the 80 million units of unexploded ordnance left from the war which ended 50 years ago. 

The UXO Problem

From 1964 to 1973, Laos endured more than 2 million tonnes of cluster bombs during the Vietnam War, making it the most bombed country per capita. Cluster bombs, extensively used in the Vietnam War, release numerous smaller bombs (bombies), notorious for often not exploding on impact. Of the 270 million bombs dropped, around 30% remain as unexploded ordnance (UXO). In the 50 years since the war, UXO explosions have caused an estimated 20,000 deaths or severe injuries, emphasizing the ongoing impact on Laos. Designed with the intent to cause damage, UXO accidents can lead to an array of disabilities, such as loss of limbs, severe burns and blindness. 

Inescapable Poverty

Most Laotians, including the vast majority of people with disabilities, live rurally, where an agrarian economy is predominant. However, this form of employment, reliant on physical labor, is often challenging for people with disabilities. The lack of vocational training for alternative forms of employment means people with disabilities are significantly less likely to work and independently earn a living, thus driving them into poverty. 

Living in Laos’ rural areas further distinguishes a relationship between disability and poverty. In the more remote villages, there is often limited access to basic services and other infrastructure such as adequate roads, schools and hospitals. In fact, more than 3% of Laos’ disabled population live in villages without roads, preventing their ability to access health care facilities, such as rehabilitation clinics for amputees, which could drastically improve their quality of life. This results in a relentless cycle of poverty, as people with disabilities are unable to obtain sufficient employment and cannot easily access the disability services that may be available to them. 

UXO Worsens The Cycle of Poverty 

Regrettably, many of the poorest neighborhoods in Laos face the risk of UXO contamination. Accidents can happen when people unknowingly handle or play with UXO or engage in farming, cooking or other daily activities. This threat is particularly concerning for rural farmers, as 22% of all UXO accidents occur while farming on contaminated land.

Farmers usually face the impossible decision between farming on land where UXO may be present or resist farming and suffer income losses. Either way, there is an increase in the likelihood of poverty. Around 45% of UXO accidents happen to children, potentially leaving them with lifelong disabilities and vulnerability to poverty. In addition, children with disabilities are seven times more likely to be unemployed or uneducated in comparison to children without disabilities. 

The United Nations (U.N.) found that only 4% of disabled children in Laos are enrolled in school and this is primarily due to families not receiving the disability allowances they are entitled to, and the social stigma surrounding disability where communities may exclude disabled children.  

COPE Laos

The efforts of a small-scale, nonprofit organization are improving the lives of disabled people, in particular, victims of UXO. Established in 1998, the Cooperative Orthotic and Prosthetic Enterprise (COPE) has been supporting disabled people in Laos, addressing the intersectionality between disability and poverty in Laos through the provision of health care services, which are all free of charge. This is essential for people with disabilities who are living below the poverty line. Such services include free, high-quality, individually tailored prosthetics for amputees, orthotics, assistive devices such as crutches, rehabilitation services and physiotherapy.

About one-third of individuals receiving prostheses are victims of UXO incidents. For instance, Zaythong Gaowrueng, who lost his leg in a UXO accident at 22, has experienced a transformative journey since receiving his initial prosthetic from COPE in 1999. Over time, he has received a total of 8 prosthetic legs, significantly improving his physical and mental well-being. This support has enabled him to work, earn a living and successfully reintegrate into the community that once ostracized him.

Providing Care to Remote Communities 

As well as having clinics in urban Laos, COPE’s Mobile Clinic Team visits the most remote communities where people with disabilities cannot access health care services due to barriers such as low income, a lack of infrastructure or physical inability to travel. The Mobile Clinic provides disabled people with the aid they require such as providing orthotics and immediate treatment in their own neighborhoods. If further treatment is necessary elsewhere, COPE arranges and covers all transport, accommodation and food expenses, making adequate treatment widely accessible. 

In 2016 alone, COPE’s Mobile Clinic Team aided almost 1,300 people with disabilities living in remote, impoverished communities. With the recent financial assistance from USAID, COPE actively assists thousands of disabled people and UXO victims each year, drastically improving their quality of life and enabling disabled individuals to autonomously earn a living, lifting them out of poverty. COPE’s Vientiane-based visitor center is the top tourist attraction in the capital city, according to Trip Advisor, thus spreading awareness of COPE, UXO and disability and poverty in Laos to a global audience.

Looking Ahead

There has been progression regarding the equality and inclusivity of people with disabilities in Laos, through the implementation of government policies such as the 2003 amended ‘Constitution of the Lao People’s Democratic Republic’ policy which states the equality of all Lao citizens, both able and disabled.  

In 2016, the Laos government in collaboration with the UN created a country-specific Sustainable Development Goal (SDG18): ‘Lives safe from Unexploded Ordnance’ alongside a 10-year national plan named ‘Safe Path Forward III’. Both projects aim to reduce the impact of UXO by clearing land to prevent future accidents and provide care for UXO victims highlighting the national commitment to alleviating the threat of UXO as a cause of disability. While the relationship between disability and poverty in Laos is still apparent, the number of disabilities caused by UXO accidents is declining every year.

– Lucy Jacks
Photo: Flickr