Since 1994, Hagar Cambodia has been serving women and children from backgrounds of abandonment, domestic violence, and human trafficking.  The mission of Hagar is to serve those who are cast out, rejected, and marginalized. Over time, Hagar has developed well-respected programming focused on social rehabilitation and economic empowerment.

In 2000, it became clear that an additional unserved population in Cambodia was children with disabilities. Children with Down Syndrome, autism, or other disabilities typically led isolated lives. Greatly stigmatized even within their own families, Cambodian children with disabilities had nearly no options for education, therapy, or social interaction.  Hagar established its ‘House of Smiles’ program in response.

One child that has been served by Hagar since 2000, is Vattana, who has been diagnosed with autism.  This is his story:

Vattana never knew his parents.  He was a baby when he was abandoned on the street and left to live at a government-run orphanage in Cambodia.

Growing up, Vattana was very aggressive.  When something frustrated or angered him, his behavior would become erratic and sometimes violent.  At the government center, Vattana had few opportunities to grow and develop.  His caregivers couldn’t understand his needs.  They would call him a stupid, crazy and foolish boy.  Sometimes the caregivers and other children would curse at him.

When Vattana became confused and angry, he would push people and throw things.  Many things scared him, particularly the other children and other people.  If he didn’t do what others told him, they treated him poorly, sometimes biting and hitting him. Sometimes he was slapped in the face and denied food.

Vattana was eventually diagnosed with autism and referred to Hagar’s House of Smiles program in 2000.  When Vattana came to Hagar, he had marks and bruises on his back and hands.  He was very thin.

Vattana’s autism is severe. He does not speak, and he has very limited physical mobility and understanding of what is happening in his environment.  He exhibits repetitious behaviors, like rocking back and forth, head banging, and touching and twirling objects.  He has a very limited range of interests and activities and can become upset by even the smallest change in his environment or daily routine.

Though progress is slow and challenging, Vattana has grown and developed at Hagar’s House of Smiles.  He can say a few words at one time and, though the process is difficult, he is learning new concepts and informing staff of when he needs to use the toilet and of other daily living needs.  He still has difficulty communicating with other children and adults.

Through Hagar’s emphasis on independence, community involvement, and integration in regular school activities, Vattana is growing.  He is becoming less aggressive.  He smiles more.  He is enjoying greater independence and mobility through regular quality care.  Life skills, communication skills, and literacy training are enabling him to achieve greater independence and live with dignity in the community.

Hagar’s goal is the reintegration into the community of all children in its care.  In the summer of 2009, House of Smiles found a foster family for Vattana. This was a big step forward in Vattana’s life.  A family whose son has an intellectual disability invited Vattana to be their son, too.  Hagar staff met with the local authorities and parents.  Everyone agreed to the arrangement and Hagar provided weeks of training about autism to the family and has offered the family medical assistance for Vattana.

Vattana was 17 years old when he went to live with his new family through Hagar’s Community Based Care program.  Vattana is loved and cared for by his new foster family.  Everyday he and his new brother attend school together.  They attend school at a new program which is a collaborative effort between Hagar and the Ministry of Education.  He has been placed in a special class supported by the Ministry of Education, and House of Smiles provides ongoing training and support to the family.

Hagar’s advocacy around autism is related to this story.  In June 2009, Hagar’s House of Smiles program established a third partnership with a Phnom Penh government school.  Forty more children will be served.  As at our two other partnership sites, Hagar teachers and government teachers will share classrooms. All of the other teachers and students in the school will interact with children who are typically marginalized and kept isolated.  A ‘buddy system’ will help integrate children on the playground, and parents will be trained to help out.  We are encouraged that top officials of the Phnom Penh Ministry of Education are showing keen interest in this collaboration and large numbers attended the opening ceremonies.

Jane Tafel
Executive Director, Hagar USA
2010

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The views expressed in this paper are those of the author(s) and do not necessarily represent the views of the NLM Family Foundation.