Report

Existing Situation Report on Persons with Disabilities in Turkey

jica - Japan International Cooperation Agency Turkey Office

CONTENTS
EXECUTlVE SUMMARY
1 INTRODUCTION
2 EXlSTING SITUATION
2.1 Basic Indicators ab out Persons with Disabilities
2.2 Major Issues and Problems
2.2.1 Causes of Disability
2.2.2 Rehabilitation
2.2.3 Education
2.2.4 Employment
2.2.5 Social Security
3 POLICY ON PERSONS WlTH DISABILITIES
3.1 Persons with Disabilities in 8th Five Year Development Plan
3.2 Persons with Disabilities in Government Program
3.3. Persons with Disabilities in Turkey' s Progress towards ED Accession
3.3.1 The EU Policy
3.3.2 Issues on Persons with Disabilities in EC Regular Reports
3.4. Legislative Framework
3.5. Institutional Framework
3.5.1 Institutional Set-up
3.5.2 Responsibilities and Main Activities
4 ACTIVITIES RELA TED TO PERSONS WlTH DISABILITIES
4.1 Public Institutions
4.2 NGOs
4.3 InternationalOrganizations
5 CONCLUSION AND RECOMMENDATIONS

EXECUTIVE SUMMARY

This Report is prepared with a view toward brietly describing the existing situation as related with persons with disabilities in Turkey. The existing situation is defined in terms of basic indicators, major issues, the legislative framework, main actors and their responsibilities, and ongoing and planned activities. The report terminates with recommendations for JICA for possible bilateral future cooperation in the sector.

Due to the multi-dimensional and multi-disciplinary characteristics of the field of disability, the Report collates information existing information through documents and interviews with key contact points. Rather than a country profile that requires a joint study of a team of relevant stakeholders, the Report should be considered as a guiding material for JICA in preparation of an action plan toward prospective development of cooperation project for the future.

The Report is constituted of 5 main chapters. Following the Introduction part, an overall view of the existing situation is given through most recent figures available. The legislative framework is rather very complicated due to the diversity of related topics, hence a general view is given in the third chapter. The fourth chapter includes the institutional set-up regarding organizations serving persons with disabilities, with emphasis on the primary stakeholders. In this chapter, examples of projects financed by international funding organizations are also provided. The fifth chapter is a summary of the policy framework, with particular focus on the requisites of efforts for access to the European Union. The final chapter presents a set of recommendations as made by the interviewed experts along with the main fındings and views of the Consultants as a result of the overall study.

As the Report shows, laws and regulations are in place with minor discussions, however, there is still much to contribute in terms of implementing the policies and legislation, thus improving the life quality of persons with disabilities. Particularly the role of NGOs, as recognized by the governmentalorganizations, is worth to note for establishing partnerships.

According to the results of the survey conducted by the State Institute of Statistics in cooperation with OZIDA (Prime Ministry Administration on Persons with Disabilities),

12.29% of total population in Turkey is disabled. This contributes to approximately 8.5 million persons with disabilities. Major highlights from the results of the statistics surveyare:

  • The main disability is the physical disability with a percentage of 10 among all the groups. People that are considered disabled because of having chronic illness count to 75%.
  • 603.840 people are under the age of 15 that can be stated as the top age for the compulsory 8 year primary schooL. Nearly 1 million is over the age of 65, and the age of approximately 40.000 is unknown. The rest of 6,7 million people can be considered as potentially productive for the society.
  • 12,69% of the urban population is disabled while this rate is11,67% in rural areas where some essential service s are difficult to provideo
  • Marmara is the region with the highest disability rate of 13,13% in which 10,90% having chronic illnesses. Black Sea is following Marmara with almost 13,00% disabled person rate in whieh 9,76% having ehronie illnesses. Southeastern part of the eountry seems to have the least disability rate of 9,90%, in whieh 7,18% having ehronie illnesses.
  • 36,33% of the total disabled population cannot read and write where most of them liye in rural are as (43,44%). People having chronic illnesses that contribute to nearly 75,00% have the skills to read and write.
  • For the population with physical disability, visual, hearing, speech impairment and intellectual disability, 40.97% are graduated from primary school, 5.64% from secondary school, 6.90% from high school and only 2.42% have a university degree. These rates are much less in rural areas compared to urban and decreases considerably towards university level. The situation is better for the population having chronic illnesses, ofwhich 4,23% has university degree.

One of the major causes for disabilities in Turkey is caused by mamage of relatives, which contributes to increased rate of genetic deformities and disabilities. Causes of disabilities are presented in the Report through Tables 7a-c.

There are a considerable number of persons with disabilities (40-60% of the total disabled) for all the disability categories, who have not received any medical treatment.

it is suspected that the results of the surveyare not what reality concems. This is explained to a degree by the fact that disabilities are hidden by the families. In this respect, there is considerable need for public awareness raising to be conducted by the government organizations and NGOs as well.

Rehabilitation is one of the most significant areas for improving life quality of persons with disabilities people. Currently the number of publicly owned rehabilitation centers is 62 (as of

April 2005). In addition, there are 505 private rehabilitation centers established with the lieense of SHCEK. However, these numbers are quite low for serving the disabled population, as reported by the resulting report of the First Congress on Disabilities held in Iate 1999. Most advanced rehabilitation centers are in larger cities such as Istanbul, Ankara, Kocaeli.

In terms of health care and preventive services, a program on family health was started in five pilot regions for informing the future parents of the risk factors and for providing genetic consultaney services. The Mother and Child Care and Family Planning Centers integrated into public health programs, which include matemal and infantile health and family planning, encompass additional topics such as the disadvantages of excessive births on the health of the mother and the child and the nutrition of pregnant women and the newborn.

Educational services are provided in special education schools to children and young people in five groups: the visually impaired persons, the hearing impaired persons, the physically disabled persons, the intellectually disabled and children with long-term illness. Of the children in all groups, those in a suitable condition are included in integration education in normal school s and benefit from education services through special education classes and supportive education.

According to the recent figures announced by the Ministry of Labour and Social Security, the work power rate of persons with disabilities over age 12 is 22.19%, and 77.81 % is not involved in any work power. By September 2004, 31,189 persons with disabilities have applied the Public Employment Organization of Turkey (ISKUR) and 12,920 were employed. Howeverr, 75% of the Persons. with Disabilities registered-at the ISKUR do not have any occupation.In this respect, there is profound need for vocational rehabilitation in order to increase employment of persons with disabilities with adequate level of knowledge and skills in appropriate occupations.

Currently, according to the ISKUR records, the number of persons with disabilities in line for employment is around 74,000. 15% of this amount is women. Private sector quota is 20,781.Companies that have quota but do not employ are given pena1ty. By the end of2004, a total of approximately 300,000 US Dollars have been collected from pena1ty fees, to be allocated for vocational training expenditures.

According to the records of the Ministry of Labour and Social Security, 60.28% of persons with disabilities in Turkey have access to social security. Social security institutions mainly finance rehabilitation services.

The policy framework of the central government in Turkey is reflected in the 8th Five Year Development Plan which emphasizes a trend toward family oriented social support programs for children with disabilities who need protection, with a view to give opportunity to liye and grow up with their families. The plan also stresses policies on leisure time activities, employment and social assistance for persons with disabilities. The significance prevails for the need for rearrangement of the services implemented for persons with disabilities. in this context, the works for legal arrangements executed by the Administration on Persons with Disabilities still continue. In order to enhance social assistance and social services to be provided for chilrlren, elderly, disabled, those requiring special care, poor and other group s under risk, a new institutional stmcture shall be established. This new structure should be responsible of the arrangements, administration, and coordination of all kinds of services and assistance given by the public sector.

The EU policies are important for Turkey in the process of accession. The policy of EU regarding persons with disabilities is based not only in rehabilitation of the se people but also their integration to the society and considering the issue as a human right. Their adoption to the society and giying them equal opportunities are the main starting points. Transportation, environment, public health, regional development and social policies are also considering disabilities.

Turkey has prepared a National Plan for Adoption of ED Acquis, which includes the required measures and policy changes to fully harmonize its legislation to EU. The issue of disabilities is mentioned under the 7th Sub-title (Full Enjoyment of All Fundamental Rights and Freedoms by All Individuals without Discrimination). However, neither the Chapter 13: Social Policy and Employment, nor the Chapter 18: Education, Training and Youth have specific items about persons with disabilities, a1though the issues are elaborated in regular reports.

The legislative framework for persons with disabilities includes a variety of laws, regulations and by-Iaws. The complexity of the legislation defined under laws for various governmental organizations, has lead to establishment of the OZIDA, as a coordinating and cooperation ageney, in this field.

Several amendments and additions to the legislation have been made during the membership process of Turkish Republic to EU. A law on the rights of persons with disabilities is under discussion in the parliament nowadays.

Most distinct laws that define responsibilities and duties are related with the participation, special education and employment.

In parallel with the complexity of the legislation, the institutional framework is defined by a broad range of governmental actors, to be supported by NGOs, universities and the private sector.

The main ministries which the legislation delegated responsibilities on diverse issues of persons with disabilities and disability are:

  • Ministry of Health
  • Ministry of National Education
  • Ministry of Labour and Social Security
  • Prime Ministry Administration on Persons with Disabilities Prime Ministry Ageney for Social Services and Child Protection

Others are Ministry of Interior, Ministry of Environment, Ministry of Construction and Sertlement, Ministry of Finance, Turkish Institute of Standards, State Statistics Institute, Ageney for Mass Housing, Bank of Provinces and Institute of Family Research.

Main national non-governmental organizations (NGOs) are:

  • Confederation of persons with disabilities
  • Federation ofvisually impaired persons
  • Federation ofhearing impaired persons
  • Federation of intellectually disabled persons Federation of persons with physical disability Sport Federation of persons with physical disability
  • Others

According to OZIDA records, there are approximately 342 associations and 42 foundations working on the issue mainly to save and deliver the rights of persons with disabilities. Most of the societies are located in Ankara (65). Istanbul and ızmir are following with 32 and 23 societies respectively. There are 20 foundations in Istanbul and 20 in Ankara.

Main activities of the stakeholders are mostly funded through international funds, however indirectly for persons with disabilities as target groups under broader schemes. Grants programmes of the European Commission and the World Bank are very efficient mechanisms in terms ofboth the results and also in terms ofraising awareness in the sector.

The most important conclusiye remarks and recommendations of the Report can be stated as:

Legislation

  • Together with the positive changes and new concepts of the new law, there is a strong need for supplementary regulations and financial resources for implementing the1aw. This is particularly significant in developing tools and mechanisms for encouraging employers for employing persons with disabilities, home-based care services, short-term care houses and vocational rehabilitation and guidance.

Institutional Set-up

  • The public sector is well-organized with minor overlaps and coordination problems. However, there is a big need to cooperate with NGOs to increase efficiency and effectiveness in services and for reaching a higher number of persons with disabilities. At this point, it should be pointed that NGOs are not well-organized and lack the adequate institutional capacity to perform effective activities and projects. Theyare particularly weak in project development and management.
  • Although NGO s seem to be working actively to defend the rights of persons with disabilities, it can be generalized that their works are not sufficiently comprehensive and integrated to co ver the real needs of their target group. Networking and cooperation among NGOs is rather weak. Therefore, activities of the Confederation of Persons with Disabilities and the federations on creating a network and promoting them to cooperate in diverse issues regarding persons with disabilities is an important need for the overall sector on persons with disabilities.
  • Majority of the planned activities of the NGOs are on accessibility, rehabilitation, care houses, sports facilities, awareness for preventive measures and architectural rehabilitation. Partnerships should be encouraged between governmental and non­governmental organizations. Distribution of international funds, such as the World Bank and EV grants, through governmental organizations to NGO s is a an efficient mechanism of financing needs of persons with disabilities.
  • There still remains much to do for fostering partnerships with the private sector for increasing corporate social responsibility toward increased employment of persons with disabilities as well as various other inputs 4for direct use by the target group. The National Fund supports persons with disabilities with wheelchairs, hearing aid devices, prosthesis and orthesis. However, better quality devices and equipment are needed which can directIy be granted or production of these devices can be a topic of vocational training and employment. OZIDA has recently taken initiative s to find a space for this purpose and has established cooperative links with the Ankara Chamber of Industry. However, there is still need for fund raising for provision of materials, equipment and trainers.

Education and Training

  • Training of qualified trainers and teachers working in special training is insufficient. The gap is filled by ordinary teachers and other kind of experts. There is strong need for training teachers for special education.
  • Despite the increased awareness in particularly the education sector, rehabilitation of existing school s for the use of children with disabilities is another major concem, as well as designing new buildings with accessibility criteria.
  • Supporting tools and equipment should be supplied in order to enhance effectiveness of special education.
  • Training service s should be increased on care personnel in both public and private sectors. In-service training programmes should be increased.

Awareness

  • Awareness on the subject among the society and even in the family is fairly low. There is enormous need for awareness raising, particularly in the relatively less developed parts of the country.

Accessibility

Accessibility issue is studied mainIyat academic level, and universities have projects in search for financial resources.

  • There are many accessibility projects of various sizes for persons with disabilities. Among them, a multi-participatory project is developed by the Department of Architecture of the Middle East Technical University. The project concems the development of an "Inclusive Design and Production Centre" towards increasing the life quality of persons with disabilities. This project intends to initiate aresearch centre towards a healthy inclusive society for the urban life of the city Ankara (as well as in Turkey) and broadly aims at creating awareness of the environmental problems of persons with disabilities and encouraging collaboration among persons with disabilities, academicians, researchers, professionals from different disciplines and entrepreneurs as well as NGOs, civil groups, agencies to devise innovative solutions (with all means including assistiye technologies) to the problems of this group and to enable them to play a role successfully in the commercial area in an inclusive way. The Department is willing to host this initiative and act as the core entity bringing all the other parties together and seeking and mobilizing necessary resources. it is envisaged that the Centre will have access to many other advantages if it is located in the Technopark developed by the Middle East Technical University. These advantages include, technologyand information technology infrastructure of the university, research facilities and many tax benefits presented by a private law. The centre will have a legal entity in compliance with the laws of Turkey.
  • In order to eliminate the barriers of accessibility, academic organizations have plans to establish internet based service s for various types of disabilities. For instance, Middle East Technical University Health Center plans to establish a web-based network with easy access of physically disabled university students to exercise freely in their places. The center plans to support the network with periodical check-up measurements.

INTRODUCTION

The field of "persons with disabilities" is one of the cooperation areas of nCA, on which several projects and activities have been conducted in various countries. With the needs and priorities expressed verbaBy by pertinent government organizations, JICA Turkey Office has decided to compile information regarding the existing situation of efforts and activities implemented in the country. This Report is prepared upon the request made by JICA Turkey Office, with a view to possible inclusion of the field of "persons with disabilities" among cooperation are as with Turkey.

The main purpose of the Report is to understand Turkey's actual needs in the field of persons with disabilities. For this purpose, it is expected to have a compiled information/data such as basic information of all related studies, activities, and publications in Turkey, as well as to provide information about policy on Person with Disabilities, present status, problems, laeking and needed aetions/activities in Turkey in the field of persons with disabilities.

The Report is prepared with a view toward briefly deseribing the existing situation as related with persons with disabilities in Turkey. The existing situation is defined in terms of basic indieators, major issues, the legislative framework, main aetors and their responsibilities, and ongoing and planned activities. The report terminates with recommendations for nCA for possible bilateral future cooperation in the sector.

Despite the multi-dimensional characteristies of the topic, requiring expertise from various disciplines from medicine to social sciences, and the broad range of stakehoJders, the Consultants have drawn a general picture of the problems and opportunities by collating existing information through documents and interviews with key contact points. The report, therefore, should not be regarded a "country profile" which requires a multi-disciplinary team to work together for a mueh longer study period. This has be en emphasized by the key contact points interviewed within the context of the study. The Report provides useful information for guiding preparation of an aetion plan for nCA for prospective cooperation with Turkey.

The major reference documents used for the Studyare the Report of the First Congress on Persons with Disabilities that was eonducted iri 29 N ovember- 02 December 1999 with the theme of "Contemporary Society, Life and Persons with Disabilities"; and the Country Report that was prepared by Prime Ministry Administration on Persons with Disabilities (OZIDA), covering a period of 1995-2000. it is worth to mention that the Second Congress will be hel d this year with the theme of "Local Authorities for Persons with Disabilities". Apart from these reports, the results of the study condueted by State Institute of Statistics in eooperation with OZIDA have provided a very useful data-base. The major contact points interviewed are universities that provide unbiased information within the limited time of the project. Kick-off meetings have also been made with governmental and non-governmental organizations, as well.

The Report is constituted of 5 main chapters. Following the Introduction part, an overall view of the existing situation is given through most recent figures available. The legislative framework is rather very complieated due to the diversity of related topics, hence a general view is given in the third chapter. The fourth chapter includes the institutional set-up regarding organizations serving persons with disabilities, with emphasis on the primary stakeholders. In this chapter, examples of projects financed by international funding organizations are also provided. The fifth chapter is a summary of the policy framework, with particular focus on the requisites of efforts for access to the European Union. The final chapter presents a set of recommendations as made by the interviewed experts along with the main findings and views of the Consultants as a resuIt of the overaıı study.

The Report has been prepared by focusing on the major issues in the field of disability. The topics are analyzed through describing the existing situation in terms of statistics, current policy, legislative and institutional frameworks. The institutional framework emphasizes the role and responsibilities of the primary stakeholders, and gives examples of their recent activities and projects. In this way, possible counterpart organizations can be selected for prospective cooperation projects by nCA. In this respect, it is important to note that the majority of projects funded by international organizations are not directly given for the field of disability, but rather indirectly as a component of broader context and as one of the members of target group s of programmes. However, considering the tremendous need for awareness and social responsibility for persons with disabilities, a direct funding for persons with disabilities would be very effective.

As the Report will present, there are many efforts concerted by various stakeholders on behalf of persons with disabilities, encouraged by the policies of the current government. Laws and regulations are in place with minor discussions, however, there is stilI much to contdbute in terms of implementing the policies and legislation, thus improving the life quality of persons with disabilities. Particularly the role of NGOs, as recognized by the governmentalorganizations, is worth to note for establishing partnerships. The report gives examples of a few NGO activities among many others, showing the range of actions commonly taken at NGO scale.

2 EXlSTING SITUATION

The Law on Persons with Disabilities (No: 5378, 1 July 2005 ) defines persons with disabilities as persons that have difficulties in cornpeting with daily life and meeting their daily needs and that require protection, care, rehabilitation, guidance and support service, from birth or due to loss of physical, intellectual, psychological, emotional and social abilities at various levels.

2.1 Basic Indicators about Persons with Disabilities

The most comprehensive investigation on the number and disability types have be en conducted by the State Statistics Institute in cooperation with the Administration on Persons with Disabilities (OZIDA) and the results were published in the year 2002. According to this survey, there is nearly 8,5 million persons with disabilities in Turkey, which constitutes 12,29% of the total population.

Table-l: Persons with Disabilities in Turkey:

 

Population

Nr. of Disabled Persons

%

Man

34.069.984

3.783.197

11,10

Woman

34.552.575

4.648.740

13,45

Total

68.622.559

8.431.937

12,29

The main disability is the physical disability with a percentage of 10 am ong all the groups. People that are considered disabled because of having chronic illness count to 75%.

Table-2: Groups of Disabilities:

Group

Total

% of Total

% Congenital

%Subsequent

%Unknown

Orthopedic

1,25

10

23,91

73,3

2,79

Seeing

0,60

5

20,41

76,32

3,27

Mental

0,48

4

47,92

49,89

2,19

Hearing

0,37

3

29,49

67,1

3,41

Speaking

0,38

3

46,63

50,16

3,21

Others*

9,21

75

N/A

N/A

N/A

Total

12,29

100

 

 

 

* People having chronic illnesses

603.840 people are under the age of 15 that can be stated as the top age for the compulsory 8 year primary schooL. Nearly 1 million is over the age of 65, and the age of approximately 40.000 is unknown. The rest of 6,7 million people can be considered as potentially productive for the society.

Table-3: Persons with Disabilities according to their age group:

Age Group

Total

% of Total

%Man

% Woman

0-4

63.055

3,12

157.186

105.869

5-9

319.276

3,79

183.599

135.677

10-14

78.468

3,30

157.323

121.145

15-19

297.837

3,53

155.941

141.896

0-24

379.147

4,50

195.229

183.918

5-29

534.359

6,34

254.066

80.293

30-34

585.452

6,94

267.827

317.625

35-39

615.605

7,30

271.263

344.342

40-44

690.140

8,19

290.662

399.478

45-49

743.727

8,82

318.060

25.667

50-54

734.938

8,72

294.271

40.667

55-59

676.655

8,03

274.774

401.881

60-64

680.495

8,07

278.944

01.551

65-69

620.513

7,36

261.623

358.890

70-74

484.854

5,75

208.191

276.663

75+

485.709

5,76

206.588

279.121

Unknown

41.462

0,49

7.404

34.058

Total

8.431.692

100.00

3.782.951

4.648.741

12,69% of the urban population is disabled whiIe this rate isll,67% in ruraI areas where some essential service s are difficuIt to provide.

Table-4: Persons with Disabilities according to their residence place:

 

Total [%]

Man [%]

Woman [%]

Urban

12,69

11,37

13;99

Rural

11,67

10,69

12,63

Total

12,29

11,10

13,45

Marmara is the region with the highest disability rate of 13,13% in which 10,90% having chronic illnesses. Black Sea is following Marmara with almost 13,00% disabIed person rate in which 9,76% having chronic illnesses. Southeastem part of the country seems to have the least disability rate of 9,90%, in which 7,18% having chronic illnesses. But this rate, according to the judgment of the Consultant, is probabIy because of the insufficient information, due to lower level of education and awareness, thereby information hidden by families.

Table-5: Persons with disabilities according to Geographic Regions

Geographic Region

Total [%]

Man [%]

Woman [%]

Marmara
13,13
11,66
14,59

Black Sea

12,98

11,62

14,32

Central Anatolia

12,52

10,78

14,23

Mediterranean

12,16

11,15

13,15

Aegean

11,86

10,69

13,00

Eastem Anatolia

11,80

11,28

12,30

Southeast AnatoHa

9,90

9,86

9,94

36,33% of the total disabled population cannot read and write where most ofthem live in rural areas (43,44%). People having chromc illnesses that contribute to nearly 75,00% have the skills to read and write.

For the population with physical, visual, hearing, speech and intellectual impairment, 40.97% are graduated from primary school, 5.64% from secondary school, 6.90% from high school and only 2.42% have a university degree. These rates are much less in rural areas compared to urban and decreases considerably towards university leveL. The situation is better for the population having chromc illnesses, ofwhich 4,23% has university degree.

Table-6: Other Indicators

 

Physically, visually, hearing,

People having chronic

 

speech and intellectually

 

illnesses

 

 

impaired persons

 

 

Male

Female

Male

iF emale

Proportion of disability (% of total population of Turkey)

 

 

 

2,58

 

 

9,7

 

 

3,05

12,12

8,05

111,33

Place.ofresidenee (% of total population of Turkey)

 

.

Urban

2,2

 

 

10,49

 

12,6

11,81

8,78

II 2, 18

Rural

3,16

 

 

8,5

 

 

3,74

12,59

6,95

110,04

Literae}' (% of total disabled)

 

 

 

 

 

Illiterate

36,33

 

 

24,81

 

 

28,15

148,01

9,78

135,04

Literal

63,67

 

 

75,19

 

 

71,86

151,99

90,22

164,96

pdueationallevel (% of total disabled)

 

 

 

 

Literate but w/o school

7,69

 

 

8,1

 

completion

7,95

17,32

7,42

18,54

Primary

40,97

 

 

47,1

 

47,21

132,22

54,41

142,35

 

5,64

 

6,31

 

Secondary

6,98

3,78

9,5

4,25

 

6,9

 

7,61

 

High

8,98

3,97

 

11,43

5,14

 

2,42

 

4,23

 

University

.

 

 

2,39

3,1

1,45

 

7,07

La.bor force status (% of total disabled)

 

 

 

 

 

21,71

 

 

22,87

 

Labor force participation rate

32,22

6,71

 

46,58

7,21

 

15,46

 

 

10,77

 

Unemployment

14,57

21,54

 

10,28

12,84

 

78,29

 

 

77, 13

 

Population not in labor force

67,78

93,29

 

53,42

92,79

Social Security (% of total disabled)

 

 

 

 

 

47,55

 

 

63,67

 

Having

144,84

51,41

 

62,4

64,56

 

52,45

 

 

36,33

 

Not having

155,16

48,59

 

37,6

35,44

2.2 Major Issues and Problems

 Major issues related with the existing situation of persons with disabilities are described in terms of 6 major topics:

- Causes of Disability - Rehabilitation
- Education
- Social Security

    • Employment

2.2. 1 Causes of Disability

One of the major causes for disabilities in Turkey is caused by marriage of relatives, which contributes to increased rate of genetic deformities and disabilities. Causes of congenital and subsequent disabilities are presented hereunder:

2.2. 1 Causes of Disability

One of the major causes for disabilities in Turkey is caused by marriage of relatives, which contributes to increased rate of genetic deformities and disabilities. Causes of congenital and subsequent disabilities are presented hereunder:

Table-7 a: Canses of Disabilities

 

Disability Types, %

 

Causes of congenital disability

Orthopedic

Seeing

Hearing

Mental

Genetic and hereditary deformity

16,96

23,43

19,74

22,91

Blood discordance

13,76

5,38

6,45

6.56

Birth trauma

9,73

4,75

6,03

6,52

Baby laeking oxygen during delivery

6,11

4,20

1,35

10,36

Medicine used by mother during

 

 

 

 

 

pregnaney

2,53

2,30

1,60

2,14

Infectious illness of mother during

 

 

 

 

 

pregnancy

3,31

4,19

4,41

3,33

Malnutrition of mother during

 

 

 

 

 

pregnaney

2,04

2,11

1,03

2,26

Do not know

53,34

51,91

54,99

ı 43,91

Unknown

2,22

1,73

4,40

2,00

 

Table-7 b: Canses of Disabilities

Causes of speeeh disability

%

Genetic and hereditary deformity

15,90

Hearing disability

10,31

Mental disability

10,49

Cerebral hemorrhage, eerebral damages, paralysis

4,83

Emotional problems

3,19

Accident

3,90

Illness

23,88

Other

24,55

Unknown

2,95

 

Table-7 c: Canses of Disabilities

 

Disability Types, %

 

Causes of subsequent disability

Orthopedie

Seeing

Hearing

Mental

Accident

41,17

25,45

11,03

9,33

Illness

41,20

47,38

58,44

54,98

Medicine usage

2,70

1,01

1,12

1,49

Poisoning

0,19

0,24

-

0,84

Malnutrition

0,76

0,45

0,25

0,66

Drug addietion

0,09

.0,28

-

-

Other

6,05

7,58

14,42

10,83

Do not know

5,72

15,55

2,60

18,27

Unknown

2,12

2,06

12,15

3,61

However, the existing level of pediatry clinies with medical genetic infrastmeture and hospitals with moleeular geneties laboratories is very limited.

There is considerable need for public awareness raising to be conducted by the government organizations and NGOs as well.

Some basic figures about the status of treatment are summarized below. There are a considerable number of persons with disabilities (40-60% of the total disabled) for all the disability categories, who have not received any medical treatment.

Table-8: Status of Treatment

Status of Treatment

 

 

 

 

 

 

Orthopedic

Seeing

Hearing

Mental

Speaking

Medical treatment is going on

17,08

20,30

13,02

18,07

11,27

Medical treatment was done

39,58

37,01

39,02

24,88

21,65

Medical treatment was not done

38,84

38,60

43,61

54,08

63,02

Unknown

4,50

4,09

4,35

2,97

4,07

 

 

 

 

 

 

Apparatus usage

 

 

 

 

 

 

Orthopedic

Seeing

Hearing

Mental

Speaking

Total

19,65

30,81

20,84

N/A

2,46

Urban

21,11

36,76

26,01

N/A

3,04

Rural

18,06

24,32

15,25

N/A

1,83

With a view to preventing the hereditary handicaps, a program on family health was started in fıve pilot regions for informing the future parents of the risk factors and for providing genetic consultaney services. The mother and child care and family planning centers integrated into public health programs, which include matemal and infantile health and family planning, encompass additional topic s such as the disadvantages of excessive births on the health of the mother and the child and the nutrition of pregnant women and the newborn.

For abating genetic blood diseases, the Ministry of Health conducts a thalassemia eradication program under the Law No. 3960 in the cities of Antalya, Icel, Mugla and Hatay where this disease is prevalenL Thalassemia diagnosis and treatment centers have been established in the se areas.

2.2.2 Rehabilitation

Concept of rehabilitation in Turkey includes medical, physical, psychological, social and vocational service s in order to stop or minimize disabilities from birth or a result of any injury or disease, and to enable persons with disabilities to enable persons with disabilities to be sufficient for themselves and the community, in their homes and sociallives. Rehabilitation service s provide a wide range of benefits to the persons with disabilities, such as the following:

- protection, improvement and recovery of health
- Prevention of disorders and diseases
- Prevention of development of occurred diseases
- Prevention and abandoning of social and environmental barriers
- Minimization Qf impacts of disability and diseases
-Maximization of remaining functional capacities and compensates disturbed functions
-Prevention of possible secondary disabilities
-Maximization of life quality to the possible best quality
-Provision of independence at home, at work, and in sociallife
-Helps to manifest the potentialities of talents along with physical ordering.
-Provides vocational consultancy and training, job allocation and harmonizing in work life for helping persons with disabilities to return to their work, or select an appropriate new work
- prevents factors that may occur as a result of inactivity and that may cause possible disorders in the metabolic, circulatory, respiratory, muscle-skeleton and urinary systems, psychological and general health condition, and prevents such factors that may prevent performing of remaining functional capacity
-accomplishes the best possible level in daily life, be self suffıcient at home and in his environment and integrate with the society
-transforms persons with disabilities from consurner to producer
-encompasses the familyand surrounding of persons with disabilities, thus enhancing others' awareness and consciousness.

Medical rehabilitation service s are provided in state hospitals and private hospitals with rehabilitation teams in big cities, in rehabilitation centers, private clinics, and in rehabilitation units of special education schools, care houses, banks and factories. State hospitals under the Ministry of Health, Organization for Social Insurance and Arıned Forces have a total of 1987 bed capacity for rehabilitation services. Rehabilitation centers with largest bed capacities (200-300) are in Ankara, Istanbul, Bolu and Kastamonu. Smaller sized ones with 30-50 beds are in Isparta, Bursa, Kahramanmaras, Samsun, Giresun. Fundamental medical rehabilitation services are:

- medical treatment applications,
- nursıng servıces,
- nutritional and dietetic services,
- physiotherapy applications,
- occupational therapy applications,
- speech and language therapy,
- psychiatric applications and psychological consultancy services, - orthesis-prothesis applications,
- recreational (and leisure time) therapy applications,
- social workers consultaney services,
- vocational consultaney services,
- consultation service s of other medicine doctors.

In Turkey, despite difficulties in availability at all situations, possible members of a rehabilitation team are: physiotherapy and rehabilitation doctor (leader of the rehabilitation team), rehabilitation nurse, physiotherapist, occupational therapist, psychiatrist, clinical psychologist, psychologist, social worker, ortheis-prothesis technician, speech therapist, child development and education experts, diet expert, and other consultancy doctors (Le. child diseases doctor, orthopedists, ete.). Occupational therapy is a new discipline in Turkey.

The First Congress on Persons with Disabilities identify the major problems related with the rehabilitation services as summarized below:
- The number of rehabilitation centers is very low.
- The existing centers lack adequate services, staff and equipment.
- Technological development is not sufficiently transferred and applied in the rehabilitation centers.
- Cooperation between rehabilitation personnel and medical personnel is very limited.
- In some regions such as the southeastem part of the country, there are no rehabilitation centers.
- Cooperation with the universities for training of qualified rehabilitation personnel is very low.
- Encouragement and financial aids are very limited for increasing the number of rehabilitation centers and reorganizing the existing ones.
-Cooperation among the government, NGOs, universities and the private sector is very limited.
-Research to analyze working capacity of persons with disabilities is very limited.
- Rehabilitation services are generally provided for the age group of 18-35. However, early rehabilitation is very important for the visually impaired persons.

Rehabilitation services are geared to special educational service s rather than medicaL. Currently the number of rehabilitation centers under SHCEK is 62 (as of April 2005). In addition, there are 473 private rehabilitation centers established with the lieense of SHCEK. 49 of the private centers are for persons with hearing impairment, 9 for the spastic children and 415 for the intellectually Persons with Disabilities.

Major professional group s of social workers in rehabilitation centers are outlined below:
- psychological consultaney and guidance experts, - psychologists,
- psychological service in education
- special education teachers
- guidance teachers
- education programıners and teachers
- pedagogy experts
- social workers
- others

Hacettepe University and Baskent University are the two academic institutions where psychological consultancy and guidance experts get lieense for social services tlll-ough an education of 4 years. Other social workers and special education teachers graduate from social science and educational science departments of Anadolu University, Marmara University, Dokuzeylul Universityand Karadeniz University. it is estimated that around 3000 social workers are employed today.

Physiotherapy and rehabilitation doctors who are trained in medicine for 6 years and get proficiency in "physiotherapy and rehabilitation" lead the rehabilitation teams. Theyare accompanied by experts from other disciplines such as social workers, physiotherapists, child development experts, psychologists, nutritionists, special education teachers, odiologists, child education experts, nurses and other support personnel.

According to the SHCEK Regulations on Identification, Control, Care and Rehabilitation of Persons with Disabilities (Dated 19.08. 1993, No. 21673) doctors trained in medicine science, are responsible for providing health services in their field related with the disability. In this respect, theyare responsible for all controls, referral, recording of results; preparation and appIication of occupational programınes, conduct regular health seans in rehabilitation centers; informing and advising vocational training staff about health problems that inhibit rehabilitation and training program; and preparation of in-service training programs.

As for the physiotherapists, they conduct the programınes prepared and described by rehabilitation doctors. Theyassist persons with disabilities in improving their physical conditions such that they can do their daily activities independently. Physiotherapists work in cooperation with vocational training staff.

Social workers are graduated from social sciences. Theyare mainly responsible for consulting with the families of persons with disabilities and informing the rehabilitation team about their social situation; preparing and application of vocational programınes; informing families about the rights of person with disabilities; coordinating among pertinent organizations and institutions that the persons with disabilities can apply; preparing programmes for training, supervision of families and consultancy, and conducting of these programınes; and coordinating in-service training programs.

Although processes vary in hospitals, the general process for a person with disabilities for rehabilitation can be described as: diagnosis, identification of risks, preparation of a rehabilitation programıne and referral to related units (if available at the hospita1) or to other institutions such as the rehabilitation and guidance centers, special education schools, etc.

it is noted at various platforms that the number of experts from various disciplines related with rehabilitation is not sufficient, and their education is limited in terms of required level of quality.

As a more participatory and more economic means of rehabilitation, community based rehabilitation (CBR) applications are fairly new in Turkey. CBR is a very effective rehabilitation process that can respond to the urgent needs of persons with disabiIities with low income level, lacking any social security, particularly in towns and cities where rehabilitation centers and service s do not exist at alL. However, it is another matter of fact that the few initial cases have emerged from big cities such Istanbul, Ankara and Konya that aıready delivers required services to the target group. Another city where CBR is implemented is Duzce where victims of the 1999 earthquake are supported through a rehabilitation programme that started in 2000, with the leadership of the UYD, Ulasilabilir Yasam Demegi (Accessible Life Association). In other cities, municipalities as the local authorities are the driving forces cooperating with local NGOs.

2.2.3 Education

Education serviees for the persons with disabilities are provided under the control of the Ministry of National Education. Organizations affiliated to the ministry, with various roles and responsibilities such as diagnosis, voeational rehabilitation, care, and education/training are as follows:
- Guidanee and Researeh Centers
-The units related to the school guidanee serviees.
- Public and private elementary and seeondary sehools. Boarding speeial edueation sehools.
- Home-boarding special edueation sehools and classes.
-Vocational sehools and voeational edueation centers.

Special education serviees are provided with respeet to different classes of disabilities in the eountry. According to the records of 2003-2004, 21978 students are edueated in special edueation sehools. Besides, 50355 students are edueated in speeial edueation classes and integrated education.

Educational serviees are provided in speeial edueation school s to children and young people in five groups: the visually impaired persons, the hearing impaired persons, the physieally disabled persons, the intelleetually disabled persons and children with long-term illness. Of the children in all groups, those in a suitable eondition are included in integration edueation in normal sehools and benefit from edueation service s through special edueation classes and supportive edueation. Speeial edueation sehools and institutions eonsist of:
- Primary edueation school s for the visually impaired persons;
- Primary edueation sehools for the hearing impaired persons;
- Multi-program high sehools for the hearing impaired persons;
- Primary edueation school s for the physieally impaired persons;
- V ocational high sehools for the physieally impaired persons;
- Hospital primary edueation sehools;
- Education and applieation sehools (for trainable intelleetually disabled persons);
- Vocational Edueation Centers (for trainable intelleetually disabled persons);
- Job Training Centers (for intelleetually disabled adults);
- Scienee and art centers (for talented and gifted children);
- Printing house and evening art school for the visually impaired persons; and
- Special edueation classes.

To give a pieture of types of speeial edueation units, the following table gives number of classes and students for the 2003-2004 Academic Year.

Special education teaehers are trained in "Special Edueation Departments" of universities such as Gazi University, Ankara University; Anadolu University, Abant Izzet Baysal University, Samsun 19 Mayis University, Karadeniz Teknik Universityand Uludag University. The period of edueation system is 4 years. Graduates are employed in private and state schools for special edueation, rehabilitation centers and guidance and re search centers affiliated to the MoNE, as well as in private rehabilitation centers under the control of SHCEK.

To give a pieture about employment in the speeial edueation seetor, the following tables are taken from aresearch study of OZIDA. The researeh study is eondueted at guidanee and research centers and speeial edueation sehools. The table indieates the groups of experts in guidanee and researeh centers and special edueation schools.

Occupational Groups

Number

Guidance and Research Centers

 

Psychologieal consultaney and guidanee expert

212

Psyehologist

75

Psychologieal service expert in edueation

51

Special edueation teaeher

27

Guidanee teaeher

21

Education programmer and teaeher

10

Pedagogue

4

Social worker

4

Others and not stated

74

Special Education Schools

 

Class teaehers

764

Special Education Teaeher

346

Open Edueation Pre-lieense degree

141

Teachers for Hearing Impaired Children

84

Teachers for Intelleetually Disabled Children

70

Guidanee teaeher

34

Child development and edueation experts

30

Psychologieal consultaney and guidanee expert

27

Mathematies teaeher

24

Vocational High school Graduates

24

Turkish language teaeher

23

Arts and Crafts T eaeher

22

Others and not stated

737

 

2.2.4 Employment

According to the recent figures announced by the Ministry of Labor and Social Security, the work power rate of persons with disabilities over age 12 is 22.19%, and 77.81 % is not involved in any work power. By September 2004, 31,189 persons with disabilities have applied the Public Employment Organization of Turkey (ISKUR) and 12,920 were employed. However, 75% of the Persons with Disabilities registered at the ISKUR do not have any occupation. In this respect, there is profound need for vocational rehabilitation in order to mcrease employment of persons with disabilities with adequate level of knowledge and skills in appropriate occupations.

ISKUR has conducted 465 courses until today, where 6,402 persons with disabilities were trained for vocational education and rehabilitation. However, it is another fact that, despite the 47,000 quota in the pubHe seetor, only 9,000 is eurrently employed.

The current government has granted the year 2005, as the year of persons with disabilities, with a concerted focus on vocational rehabilitation.

Various projects are in progress along with increased legal enforcement toward increased employment of persons with disabilities. One of the steps taken has been the increased percentage from 3% to 4% as compulsory to employ persons with disabilities in the public sector. This value is 3% for the private seetor.

Private sector organizations that employ over their quota are encouraged by payments of insurance İncentives by the Treasury. This is one of the steps taken toward supporting employers through subsidies rather than the existing quota-penalty system. Ways and means of encouraging employment of persons with disabilities still require legislative and economic toools to develop.

Currently, according to the ISKUR records, the number of persons with disabilities in line for employment is around 74,000. 15% of this amount is women. Private sector quota is 20,781.

Companies that have quota but do not employ are given pena1ty. By the end of 2004, a total of approximately 300,000 US Dollars have been collectedfrom pena1ty fees, to be allocated for vocational training expenditures.

ISKUR runs the V ocational Rehabilitation Center in Ankara, where courses are conducted with maximum duration of 6 months. Courses are given by the experts from Hacettepe University Highschool of Physical Therapy and Rehabilitation. persons with disabilities are trained for development of skills together with pertinent behavioral and physical treatment.

The following table shows placements of persons with disabilities in 2004, with respect to the parameters of gender, degree and type of disability and education level.


 

Table 10: Number of Disabled Placements by Types of Disability, Degree of Disability and Education by Year 2004

 

 

 

 

 

Female

Male

Total

Degree of disability

40

60

 

1.303

5.640

6.943

 

61

80

 

124

758

882

 

81

100

199

693

892

 

 

 

 

TOTAL

1.626

7.091

8.717

Type of Disability

 

 

 

Hearing

46

227

273

 

 

 

 

Speech

6

31

37

 

 

 

 

Hearing and

 

 

 

 

 

Speec

h

33

162

195

 

 

 

 

Intellectual

16

152

168

 

 

 

 

Physical

1.067

3.588

4.655

 

 

 

 

Visual

302

1.772

2.074

 

 

 

 

Other

156

1.159

1.315

 

 

 

 

TOTAL

1.626

7.091

8.717

Education

 

 

 

Primary

276

2.189

2.465

 

 

 

 

Secondary

711

3.295

4.006

 

 

 

 

High school

278

731

1.009

 

 

 

 

Higher

 

 

 

 

 

Education

361

876

1.237

TOTAL 1626 7091 8717

Souree: Presideney of State Personnel, 2004.

 

2.2.5 Social Security

According to the records of the Ministry of Labour and Social Security, 60.28% of persons with disabilities in Turkey have access to social security. Social security institutions mainly

finance rehabilitation services. Please refer to Chapters 4-5 for institutional and legal aspects of the social security issue.


 

3 POLICY ON PERSONS WITH DISABILITIES

 

3.1 Persons with Disabilities in sth Five Year Development Plan

 

Five year development plans are the main national planning documents which functions as a framework for the main implementations and investments for the forthcoming 5 years in the eountry. The gth Five Years Development Plan ineludes several elauses and statements regarding persons with disabilities.

Under the title of Development of Human Resources, (sub-title Woman, Familyand Children) it is stated that emphasis should be given to social support programs towards family in order to protect and raise children with disabilities in need of protection within their family environment, because families are the ideal and priority environment in caring and raising a ehild. Family oriented social support programs are emphasized for children with disabilities who need protection, with a view to give opportunity to liye and grow up with their families. it is aimed to develop alternatiye caring models to be extended for the children who are homeless and living with their families and relatives.

Inside the same part, under Leisure Time Activities, central and local administrations as well as universities are focused with a view to improving infrastmcture and manpower capacities for leisure activities for all sections of the society, partieularly children, the youth, the elderly, housewives, homeless and persons with disabilities, in a productive and participatory way.

Non-governmental organizations and the private sector are aimed to be encouraged to support in these aspects.

Special emphasis is given to the employment of persons with disabilities. Necessary legal and institutional arrangements are focused in relation to those groups in working life, which need a specia! interest, especially to women, children and persons with disabilities.

it is also noted in the gth Five Year Development Plan regarding the Social Services and Social Assistance that the significance prevails for the ne ed for rearrangement of the services implemented for persons with disabilities. In this context, the works for legal arrangements exeeuted by the Administration on Persons with Disabilities still continue.

 

3.2 Persons with Disabilities in Government Program

Persons with Disabilities are considered in all government programs. The most recent government program is the 59th program prepared and executed by the Justice and Development Party (AK Parti). The program mentions the basic concept of social state and considers persons with disabilities among all the disadvantaged groups as an important part of the society. Integration of persons with disabilities into the society, providing them equal opportunities in social and economic life and securing their right and access to education are considered as the main duties of the 59th government.

To this end, AK Party has established the Coordination Center for Persons with Disabilities. In line with the policy of the government, it is envisaged that the center wİll conduct studies towards integration of persons with disabilities to the society. Local centers investigate and

monİtor the conditions of persons wİth disabilities, inforın the public on basic rights of persons with disabilities and major issues.

 

3.3 Persons with Disabilities in Turkey's Progress towards EV Accession

3.3.1 The EUPolicy

The policy of EV regarding persons with disabilities is based not only in rehabilitation of

these people but also their integration to the society and considering the issue as a human right. Their adoption to the society and giving them equal opportunities are the main starting points. Transportation, environment, public health, regional development and social policies are also considering disabilities.

The European Social Charter was accepted in 1989 by II member countries (except Great Britain). During the Maastricht Summit, the member countries (except GB) agreed to extend the efforts of the Charter i.e. health, security and integration of excluded people to the labor force. The Social Charter encompasses 12 principles, that one of them is "better social and economic integration for persons with disabilities".

The legislation in the social field includes minimum standards in areas such as labor law, equal treatment of women and men in employment and social security, and health and safety at work.

Turkey has prepared a National Plan for Adoption of EV Acquis. This plan includes the required measures and policy changes to fully harmonize its legislation to EV. Regarding the persons with disabilities, th Sub-title (Full Enjoyment of All Fundamental Rights and Freedoms by All Individuals without Discrimination) under the Political Criteria section, mention persons with disabilities as "Appropriate measures will be taken in line with the ILO Convention No. 159 for the Vocational Rehabilitation and Employment for Disabled Persons". Neither the Chapter 13: Social Policyand Employment, nor the Chapter 18: Education, Training and Youth have specific items about persons with disabilities, although the issues are elaborated in regular reports..

 

3.3.2 Issues on Persons with Disabilities in EC Regular Reports

As part of the pre-accession strategy, the European Commission reports regularly to the European Council on progress made by each of the candidate countries in preparing for membership. Consequently, the Commission has published a series of yearly Regular Reports on Turkey, covering the years 1998 to 2003.

Although persons with disabilities are not mentioned in related chapters of the National Plan, Regular Reports inelude policy aspects about persons with disabilities. This is because ED considers the issue as a basic human right that should be considered in social policyand economic life.

Despite the adoption of a new Labor Law in 2003, which recognizes the principle of equal treatment in employment, Turkey still lacks legislation against discrimination on the basis of all prohibited grounds, such as racial and ethnic origin, religion or belief, age, sexual orientation and disability. The first periodic report under the UN Convention on the Elimination of All Forms of Racial Discrimination, which was due in October 2003, has stiıı not been received by the UN.

in Chapter 13: Social Policyand Employment, specific binding mles have been developed in public health (on tobacco control and surveillance and control of communicable diseases) and recently also with respect to non-discrimination on grounds of racial or ethnic origin, religion or belief, disability, age or sexual orientation. The European Social Fund (ESF) is the main financial instrument through which the ED supports the implementation of its Employment Strategy and contributes to social inclusion efforts. The Member States participate in social dialogue at European level and in ED policy processes in the areas of employment policy, social inelusion and social protection.

The circular issued in July 2004 regarding the quota of persons with disabilities or ex -conviets in the public institutions was stated as the main progress in the year 2004.

As an overall assessment it is stated that the existing structures to promote social inclusion are highly dispersed and there is insufficient coordination of activities. it is important to promote an integrated approach mobilizing various governmental bodies and all relevant stakeholders in the process. Efforts to bring social statistics on poverty and social exelusion into line with the ED's commonly agreed indicators on social inelusion should continue. W ork stiıı remains to be done in particular to improve the situation of persons with disabilities. More importance should be given to strengthening central and decentralized structures and facilities for persons with disabilities, including improving access to education for children with disabilities. Joint work between Turkey and the Commission on the drafting of a Joint Memorandum on Social Inelusion (JIM) to identify

key cha1lenges and relevant policy responses to promote social inelusion started in the last quarter of 2004. in the field of social protection, the Government should pursue its ongoing efforts aimed at bringing about a reform of the social security system. Its main current weaknesses remain the laek of financial stability, the presence of a large informal sector and administratiye and management problems. Efforts currently undertaken to upgrade the administratiye capacity of the social security institutions are also strongly encouraged.

In Chapter 18: Education and Training, it is stated that a law of 1997 provides for compulsory pre-sehool education for children with disabilities, but the attendance rate of such children remains extremely low. Turkey needs to make substantial efforts to provide facilities and to convinee eoncemed families to send their children with disabilities to school."

 

3.4 Legislative Framework

The histoncal backgrounds of persons with disabilities in Turkish legislation begin with the protection of children which needs special care. The first step was the International Geneva Agreement that mentioned children with disabilities in the context of rights of children. The Special Care Centers/Institutes concept was founded by the "Regulation on Children Requiring Special Care" in 1949. Responsibility of Special Care Centers was transferred from Ministry of Health to Ministry of National Education (MoNE) in 1951, by accepting that the disabilities are subject to education besides beingjust a subject of health.

As a result of the efforts of Alti Nokta Koder Dernegi (Six Point Blind Association), the aspects of disabilities were introduced to Turkish Constitution in 1961. A law (Law Nr. 6972) was set into force to secure the service s and to take necessary measures for the children requiring special care by the MoNE in 1957. With the Law of "Institute for Social Service s and Protection of Children" in 1983, it was fixed that the education of the children with disabilities will be done in the schools of MoNE and other government education facilities. After the Constitution of 1961, special items are added to the Law of Pnmary Education regarding special education and subsequenHy Regulation of Special Education was set into force. A special unit was formed to train the teachers specialized in persons with disabilities education in Ankara University in 1965. With the Law of National Education (Law Nr. 1739) announced in 1976, special education is considered as an integral part of the education system.

In general, because of the basic philosophy of social state, persons with disabilities was considered equal to other citizens and their rights on education and integration to social and economical life was secured by severallaws and regulations.

Rehabilitation of persons with disabilities was studied and governmental and civil centers were erected in 1960ies. A law (Law Nr. 2022) securing the employment and a certain level of livelihood for unemployed persons with disabilities and the ones over the age of 65 was set

into force in 1976. Law of Labor (Law Nr. 1475) was amended to fix an employment quota of 2% for disabled person in 1971.

The Constitution of 1981 states that; it is the duty of the State to secure the necessary services forpersons with disabilities (ltems 42,50,56,59,61).

The Turkish Government accepted the International Agreement of ILO (Agreement Nr. 142) regarding the employment and job training by the Law Nr. 3850 in 1992 (Official Gazette Nr. 12.12.1992/21433). This agreement secures the equal opportunity of persons with disabilities in economic life specifically for the job trainings.

When the Law of Associations came into force in 1983 (Law Nr. 2908), all the civil initiatives and NGOs working on the four major disabilities have to be a member of federations that is linked to a nationwide umbrella confederation (Turkish Confederation of Disabled Persons).

A special center was formed (Administration on Persons with Disabilities) to deal with the diverse issues of persons with disabilities with the respective law in 1997.

 

Several amendments and additions to the legislation were also done during the membership process of Turkish Republic to EV. A law on the rights of persons with disabilities is under discussion in the parliament nowadays.

Act 571 describes the principles for the implementation of services for persons with disabilities. Principles of this act are set abouı:

Promoting equal participation of persons with disabilities to social life, increasing awareness and sensitivity about persons with disabilities in society, providing adequate and suffıcient medical care and rehabilitation, and promoting mobility and independent living abilities of disabled individuals.

Promoting accessible information, services and physical environment for persons with disabilities.

The provision of equal educational opportunities for persons with disabilities throughout the life span.

The provision of improvements in employment facilities for disabled individuals, in other words, rearranging work environments and redesigning equipments/instruments according to the needs of persons with disabilities and precautions.

Guarantying social security, revenue, and protecting family life and personal integrity/unity of persons with disabilities and of ensuring their full participation in cultural, recreational, sporting, and religious activities.

Guarantying full participation of persons with disabilities in the decision-making processes for actions toward persons with disabilities.

To compensate for the experienced problems in the field of special education and to improve the quality of education for individuals with special education needs Act 573 was legislated in 1997. "Act of Special Education" describes the implicit and explicit educational service s that are to be provided to disabled individuals. it also defines programs, schools and institutions that would provide these services. As this act states the right of disabled individuals to benefit from early intervention, preschool, elementary, secondary, and high school education system, mainstreaming was guaranteed. Act 573 brought a new perspective to service s in the area of special education. With its principles:

All individuals with special education needs are given the right to be educated. Accordingly, children with disabilities who were previously disregarded or restricted from exercising their educational rights are given the opportunity to benefit from education.

- Inelusive education/mainstreaming is anticipated.

- Adaptations of the programs according to the needs of children with disabilities are

anticipated, when developing educational programs for children with special needs.

- Child-centered education is suggested, because individualized educational programs require preparing according to the unique performance/needs of the disabled child.

- It is suggested that a child's educational needs and developmental features are taken into account rather than his or her degree of disabiIity, when making decisions about special education replacement.

- The preparation of educational programs according to the performance of children is anticipated. This provides children with disabiIities the chance to be educated without being labeled.

- Classification applications based on discriminative labels are ended.

- Early intervention practices are suggested to be delivered at homes and institutions. In

addition, children are provided with the right to benefit from preschool education institutions.

- Parents are given rights and responsibilities in the decision-making process regarding the replacement of their children with disabilities.

-it is suggested that parents have right to be informed about educational progress of and outeomes of the educational programs.

-Individuals with special needs are given opportunities to be educated in the least restricted environment.

-Early special education and continuity in education opportunities are enabled.

-it is anticipated that providing support in terms of staff and educational programs will inerease the quality of education provided by private sector (either by private enterprises or by the foundations for disabled individuals).

Despite that the Turkish Constitution indudes artides about persons with disabilities as a social group that has to be protected, the pertinent legislation has undergone through steps of development in the past couple of years. The need for a new regulation arose from lack of proper government policies, dispersed nature of respective responsibilities among different legislative texts and institutes, and lack of standards in identification and required service s for persons with disabilities as well as the necessities for introducing new concepts such as the c1assification of disabilities. There was also a strong need on updating the old regulations with respeet to intemationally accepted approaches such as accepting the disability as a human right issue and avoiding discrimination in social and economic life.

The new Law on Persons with Disabilities (Law No. 5378) has been enacted with a series off amendments on the former law on 1 July 2005 . The aim of the new regulation, which eneompasses the umbrella codes, is set as to secure the rights of persons with disabilities and to establish eoordination of efforts. The new law indudes definitions of disability, criteria for disabilities and rehabilitation. Major accomplishments brought about with the new law can be outlined as follows.

- ICF (International Classification of Functioning) system will be applied in stead of the health board reports applied until today,
- Care services will be improved under the overall control of SHCEK
- Active participation of persons with disabilities, their families and NGOs will be secured through various means such as improved rehabilitation service s, physical accessibility, support teehnologies and equipment for sports activities, etc.
- Vocational rehabilitation services will be disseminated wide, and municipalities (Iocal authorities) will also deliver these services.
- Employment of persons with disabilities will be encouraged through measures against diserimination, improvement of physical accessibility at work places, encouraging proteetive work places, increased penalty measures, etc.
-Supporting and facilitating educational services through financial supports, coordination of support activities for university students, preparation and supply of various education materials.
-Providing financial support through increased monthly salaries of the persons with disabilities,
-Fostering new preventive measures against disabilities,
- Improving local services through establishing special units in municipalities for persons with disabilities

3.5 Institutional Framework

3.5.1 Institutiona1 Set-up

After the announcement of 1983-1992 Disabled Persons Decade by UN, the National Coordination Council for Protection of the Disabled Persons has been established und er the Ministry of Labor and Social Security in 1981. This body was in charge until 1997. The Administration on Persons with Disabilities under the Prime Ministry was then established in 1997.

Administration on Persons with Disabilities is the coordinating body for all the aspects of persons with disabilities. Formulating policies, investing in developing measures for the problems of persons with disabilities are also the main duty of this administration.

The Council of Disabilities established under this administration and the Disabilities Summit is the main body for formulating and directing the national policy on persons with disabilities.

The main ministries which the legislation delegated responsibilities on diverse issues of persons with disabilities and disability are:
- Ministry of Health
- Ministry of National Education
- Ministry of Labour and Social Security
- Prime Ministry Administration on Persons with Disabilities
- Prime Ministry Ageney for Social Services and Child Protection

Others are Ministry of Interior, Ministry of Environment, Ministry of Construction and Settlement, Ministry of Finance, Turkish Institute of Standards, State Statistics Institute, Ageney for Mass Housing, Bank ofProvinces and Institute of Family Research.

Main national non-governmental organizations (NGO s) are:
- Confederation of persons with disabilities
- Federation of visually impaired persons
- Federation of hearing impaired persons
- Federation of persons with intellectual disability
- Federation of persons with physical disability
- Sport Federation of persons with physical disability - Others

All the NGOs are obliged to be a member of the above federations and thus to the confederation. According to OZIDA records, there are approximately 342 associations and 42 foundations working on the issue mainly to save and deliver the rights of persons with disabilities. Most of the societies are located in Ankara (65). Istanbul and ızmir are following with 32 and 23 societies respectively. There are 20 foundations in Istanbul and 20 in Ankara.

3.5.2 Responsibilities and Main Activities

The major actors responsible for provision of basic services for persons with disabilities are indicated in the table below, with their main responsibilities.