For several years now, the Republic center for Support of Persons with Intellectual Disability – PORAKA cooperates with the Association for Emancipation, Solidarity and Equality of Women – ESE. This cooperation resulted in the manual for protection of the rights of patients with focus on persons with intellectual disability, which has been prepared and published within the project “Human rights in health protection” implemented by ESE.
The Republic center – PORAKA, on ESE’s request took part in the preparation of a submission to the UN Committee on Economic, Social and Cultural Rights regarding the International Treaty on Economic, Social and Cultural Rights. This submission highlights the problems associated with non-fulfilment of the Right to health (article 12 of the International Treaty on Economic, Social and Cultural Rights and General comment no.14) by several vulnerable groups: Roma people, people living with HIV/AIDS, drug users, women, people with rare diseases, people with intellectual disability and victims of trafficking in human beings. The submission, inter alia, aims at contributing to the consideration and formulation of the List of issues at the Committee ‘s Pre-Sessional Working group in October 2015, and to raise questions to the Government of RM for the fulfilment of the right to health as regulated in the Covenant. In the preparation of the submission, besides the Republic Center – PORAKA, other seven civil associations also took part.
The parts that refer to the Right to health of persons with intellectual disability that are included in the submission are the following:
HEALTH OF PEOPLE WITH INTELLECTUAL DISABILITY
Certain age group of people with intellectual disability is faced with limited access to free health care, treatment and medication. Namely, the Law on Health Insurance stipulates the exemption from participation in the use of health care services only for children, i.e. for people with intellectual disability up to the age of 26, but not afterwards. Specialized health services, programs and facilities for children and people with intellectual disabilities are provided only on national level. Early detection, assessment and treatment for the children with intellectual disability is done in the developmental counseling offices in Skopje and Bitola and the Institute for mental health of children and youth “Mladost“ in Skopje. The Institute for medical rehabilitation in Skopje provides physical rehabilitation for the people with intellectual disability. The Institute for rehabilitation of the hearing, speech and voice (Skopje and Bitola) conducts rehabilitation programs also for children with intellectual disability at preschool and school age.
People with intellectual disability and their parents are often faced with inadequate attitude by the medical staff, especially in the specialist consultative health care and hospital facilities. 57% of the interviewed people with intellectual disability and their parents are dissatisfied from the health services.
The system for assessing the specific needs of the people with physical and intellectual disability is obsolete and insufficiently developed. The assessment (categorization) is carried out by several regional committees and furthermore, the findings and the opinion from the assessment do not include the list of needs and recommendations for further treatment of these people.
The rulebook on the realization of the right to mobility is not applicable to individuals with intellectual disability and it imposes a use of a “wheelchair” as a precondition for the exercise of this right. Namely, individuals with severe and profound intellectual disability as well as people with combined disabilities, although they do not use a wheelchair, are not in a position to move around independently and without an escort.
The submission, as already mentioned, aims at consideration and formulation of the List of issues at the Committee‘s Pre-Sessional Working group in October 2015, and to raise questions to the Government of RM for the fulfilment of the right to health as regulated in the Covenant. The List of issues that are supposed to raise to the Government of RM and refer to the health of persons with intellectual disability is as follows:
• Why does the Government of RM exempt from co-payment for realization of the right to health care only children/individuals with intellectual disabilities of up to 26 years of age and what measures will it take to expand the realization of this right by all the others regardless of their age.
• What are the measures undertaken by the state to overcome the inappropriate treatment by health care professionals of persons with intellectual disability?
• What are the measures undertaken by the state aimed at overcoming the shortcomings of the existing system in categorizing disabilities?
• What are the measures undertaken by the state to ensure the exercise of the right to mobility of persons who do not use a “wheelchair “?
