Mexico s Diagnostic on Disability Prepared for The Japan International Cooperation Agency (JICA), Office in Costa Rica

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1 1 Mexico s Diagnostic on Disability Prepared for The Japan International Cooperation Agency (JICA), Office in Costa Rica by María Eugenia Antúnez Farrugia Andrés Balcázar de la Cruz

2 2 1. Table of Contents 1. Table of Contents Abbreviations Basic Profile Philosophical Frame Approach on Disability Conceptual Frame Mexican definitions Definitions according to People with Disabilities Law Definitions according to General Health Law Legal Framework Ratified International Treaties Laws Legal Framework interpretation and implementation Management and Organization of Disability Issues Director Body Public Sector Organizations The Roll of Civil Society Organizations Disability related International Cooperation Actions Public Policies Information Registry Census Information obtained visited institutions that have public information or from the ones that answered upon request Disclosure and Application of ICF Proposed Indicators Persons with Disability s Population Profile, according to the Geography and Data Processing National Institute (Data from the General Census of Population and Housing 2000) Basic Data Education Labor Health Current Situation Health Education Labor Information and Communication Social Security Accessibility Housing Transport Community Based Rehabilitation Discrimination Conclusions... 49

3 3 12. Bibliography Documents Interviews Appendix 1, Results regarding disability from the National Health Survey Aprendix 2, Information from Teleton Foundation Anexo 4, Actividades de la Asociación Piña Palmera A.C

4 4 2. Abbreviations APAC CMIC CANADEVI CNDH CODIS CONADE CONAFOVI CONAPO CONAPRED CONFE DIF DIF-DF FONHAPO FOVISSSTE IMSS INDAABIN INEGI INFONAVIT ISSSTE INR INSP NOM ONU ORPIS PREVER-DIS PROFECO SAGARPA SCT SEDESOL SEP SHF STPS Association in Favor of Persons with Cerebral Paralysis National Chamber of the Building Industry National Chamber of the Housing Development and Promotion Human Rights National Commission National Advising Council for the Integration of Persons with Disability National Sport Commission National Commission on Housing Development National Council of Population National Council for the Prevention of Discrimination Mexican Federation of Organizations in Favor of Persons with Intellectual Disabilities. National System for the Family s Integral Development National System for the Family s Integral Development, Mexico City Branch National Fund for Popular Housing Housing Fund of the Institute of Services and Social Security of the State s Workers Mexican Social Security Institute Institute for the Administration and Economic Evaluation of National Facilities National Institute of Statistic, Geography and Data Processing Institute of the National Fund for Worker s Housing Institute of Services and Social Security of the State s Workers National Rehabilitation Institute National Public Health Institute Official Mexican Standard United Nations Mexican Presidency s Office for the Promotion and Social Integration of Persons with Disability Program of Action for the Prevention and Rehabilitation of Disabilities Consumer Protection Federal Bureau Ministry of Agriculture, Rural Development, Fisheries and Food Ministry of Communications and Transports Ministry of Social Development Ministry of Public Education Federal Mortgage Society Ministry of Labor and Social Prevision

5 5 3. Basic Profile Indicator Total Population 81,249,645 91,158,290 97,483,412 Average population annual growing rate a/ Fertility Rate b/ Mortality Rate Life Expectancy Average Age Schooling Average 6.6 ND 7.3 Schooling Delay Rate Economic participation rate c/ Unemployed Population 659,870 ND 424,644 Total of Houses (family houses) 16,035,233 19,361,472 21,513,235 Average occupancy per house Population with Disability ND ND 1,795, Población hablante de lengua indígena 5,282,347 5,483,555 6,044,547 Percentage of Catholics 89.7 ND 87.9 Percentage of rural population Data of 1990 correspond to period; for 1995, to ; and 2000, for a/ period. b/ Data of 1990 correspond to c/ Data of 1990 correspond to d/ Refugees nor houses without information of occupants included ND Not Available Source: INEGI. XI General Census of Hosing and Population Aguascalientes, Ags INEGI. Counting of Population and Housing, Aguascalientes, Ags INEGI. XII General Census of Hosing and Population, Aguascalientes, Ags CONAPO. Mexico s Population Projections

6 6 4. Philosophical Frame 4.1. Approach on Disability Since 1995 the country has tried to put aside the medical model and adopt a human rights and developmental oriented approach, establishing in that year the CONVIVE Program. Later on, in the year 2000 President Vicente Fox established the Mexican Presidency s Office for the Promotion and Social Integration of Persons with Disability (ORPIS) and the National Advising Council for the Integration of Persons with Disability (CODIS). In June 2005 the Mexican Congress passed the General Law for Persons with Disabilities which represented a step backwards (to the medical model), as the Ministry of Health is now the responsible of all disability issues. Additionally the Law mandates the abolishment of ORPIS and CODIS. 5. Conceptual Frame 5.1. Mexican definitions Definitions according to Mexican Official Standard NOM- 173-SSA1-1998, for integral attention to people with disabilities. Disability: absence, restriction or loss of skill to perform an activity in a certain way or within certain limits, which are considered normal for a human being. Rehabilitation: set of measures designed to improve the capacity of a person to perform by himself/herself the necessary activities for his/her physical, mental, social, occupational and economical development, through orthesis, prosthesis, functional aids, reconstructive surgery or any other procedure which allows him/her to integrate into society Definitions according to People with Disabilities Law. Disable person: Any person having a physical, mental or sensitive deficiency, either of permanent or temporary nature, limiting his/her capacity to perform one or more essential activities of common life, which may be caused or worsen by the economic or social environment.

7 Rehabilitation: limited lasting process with a defined objective of medical, social and educational order, among others, aimed at providing the means to facilitate a disable person to reach an optimum physical, mental or sensitive standard, so he/she may compensate the loss of a function as well as to provide him/her with a better social integration Definitions according to General Health Law. This law (amended in June, 2005), does not mention the term people with disability, simply referring to invalidity with the following definition: the limitation on a person s capacity to perform by himself/herself, the necessary activities for his/her physical, mental, social, occupational and economical development, as a consequence of having a somatic, physiological or social insufficiency. 4.2 Legal Framework Ratified International Treaties International Labor Organization: C159 Vocational Rehabilitation and Employment (Disabled Persons) Convention, 1983 Ratified by Mexico on April 5th 2001 Inter American Convention on the Elimination of All Forms of Discrimination Toward Persons with Disabilities Ratified by Mexico on January 25th Laws [Title] Persons with disabilities General Law [Issuance Year] 2005 [Purpose] To establish the grounds for allowing the full inclusion of persons with disabilities in all aspects of life, within a frame of equally and compared opportunities. [Description] Allows the implementation of Public Political Programs, created since seven years ago, at a national level. [Title] Federal Code for Voting Institutions and Procedures [Issuance Year] 1990, last amendment in [Purpose] To regulate the constitutional rules regarding the political/electoral rights and obligations of citizens; the organization, functions and prerogatives of political parties and groups; and the state function of organizing the election of members for Legislative and Executive Powers of the country. [Description] Allows physically unable voters to mark and cast a vote, to be assisted by a trusty person of his/her own accompanying him/her. 7

8 8 [Title] Federal Civil Code [Issuance Year] 1928, last amendment: 2004 [Purpose] [Descripción] Does not refer to disability but to legal incapacities only including minors and The people with lack of or decreased intelligence or distraught of her, although they have lucid interval; and those that suffer any affection originated by disease or continuing deficiency of physical, psychological or sensorial character or for the addiction to toxic substances, like alcohol, psychotropic or narcotic drugs [Title] Customs Law [Issuance Year] 1995, last reform: 2002 [Purpose] To regulate all merchandise coming in or going out of our national territory as well as the means of their transportation, the functioning of customs offices, and the facts or actions derived from its functioning and of the mentioned movement of merchandise. [Description] Exempts all foreign commerce tax payments for those special or adapted vehicles and all other merchandise, imported by people with disabilities when they make personal use of them, as well as for those imported by non-tax payers moral persons (companies), authorized to receive non-taxable donations over income tax, which dedicate themselves to take care of these people providing that such merchandise, as per its characteristics, replace or diminish their disability, allow the physical, educational, professional or social development of such people, be used exclusively and permanently by them, and have the Secretary authorization. [Title] Airports Law [Issuance Year] 1995 [Purpose] To regulate construction, administration, operation and exploitation of civilian airports. [Description] Specifies that concessionaires and licensed persons of civilian airports, must adopt the necessary measures to allow adequate treatment to persons with disability, as well as those of advanced age. [Title] Civil Aviation Law [Issuance Year] 1995, last amendment: [Purpose] To regulate exploitation, use and development of aerial space over the national territory, regarding the benefit and development of civil and state aerial transportation services. [Description] Indicates that concessionaires and licensed persons must adopt the necessary measures to allow adequate treatment to persons with disability, as well as to those of advanced age. [Title] Physical Culture and Sports General Law [Issuance Year] 2003

9 9 [Purpose] To promote the optimum and ordered development of physical culture and sports in all their manifestations and expressions. [Description] Indicates that all sportsmen with certain type of disability will not be subject to any kind of discrimination, providing that the activities to be performed do not endanger their integrity. The National Sports Commission (CONADE) has the authority to formulate programs in order to promote physical culture and sports among persons with disability. Indicates that planning and construction of physical culture and sports facilities financed by public funds, must allow their normal use by people with any disability. Programs for physical culture activities training, should be elaborated by CONADE together with departments and entities of Federal Public Administration; Federal Entities Governments; Federal District Government (Mexico City); Municipalities; public, social and private organizations, national and international; contemplating training over people with any kind of disability. [Title] Income Tax Law [Issuance Year] 2002, last reform: 2004 [Purpose] Physical and moral persons obligations regarding income tax payments. [Description] Employers hiring people with disabilities will be able to deduct from their income an equivalent amount of 100 % of the income tax applicable to those workers. [Title] Security Institute and Social Services of State Workers Law [Issuance Year] 1983, last reform: [Purpose] [Description] This law still uses the term: incapacity. It provides that physical and mental rehabilitation services are obligatory. Registered workers may include their incapacitated relatives over 18 years old or spouse, presenting an incapacity certificate issued by the institute itself. The worker is entitled to a pension in case that a temporary or permanent incapacity is declared, derived from job risks. [Title] Social Security Law [Issuance Year] 1995, last reform: [Purpose] To guarantee the right to health, medical assistance, protection to sustenance means and necessary social services for the individual and collective welfare, as well as the right to be granted with a pension.

10 10 [Description] Provides that preexistence of such conditions as physical, mental or sensitive disability, intoxication or chronicle illness, is not a cause to diminish the temporary or permanent incapacity grade, neither the benefits assigned to a worker. In order to protect health and prevent illnesses and disability, the medical prevention services of the institute will establish diffusion programs over health, disability prevention and rehabilitation, epidemic studies, manufacture of immune biological products, immunizations, sanitary campaigns and other special programs focused in solving medical-social problems. [Title] Consumer Protection Federal Law [Issuance Year] 1992, last reform: [Purpose] This law s objective is to promote and protect the rights and culture of consumers and procure juridical fairness, certainty and security over suppliers-consumers relationships. [Description] Specifies that suppliers of goods, products or services will not be able to place a condition or deny their delivery to consumers because of their gender, nationality, ethnos, sexual preference, religion or any other particularity, neither exclude people with disabilities, except for causes affecting the establishment security and peaceful environment of customers or of disable people themselves. It also provides that no extraordinary or compensatory charges may be applicable to people with disabilities because of their medical, orthopedic, technological, educational or sporting implements, needed for their personal use, including a leading dog in case of blindness. Suppliers are obliged to grant any facilities or essential devices so people with disability could use the goods or services they offer. Such goods and services may not be inferior to those determined by legal provisions or applicable official rules, neither suppliers may establish conditions or limitations reducing legal assigned rights to disable people as consumers. [Title] Human Settlings General Law [Issuance Year] 1993 [Purpose] I. To establish the conjunction of the Federation, federal entities and municipalities, to regulate and arrange human settlings in the national territory; II. To determine basic rules for planning and regulating the territorial arrangement of human settlings and the foundation preservation, improvement and growth of population centers; III. To define principles to determine provisions, reserves, uses and destination of areas and properties which will regulate properties in population centers, and;

11 IV. To determine basis for social participation over human settlings. [Description] Establishes that the territorial arrangement of human settlings and the urban development of population centers, will have a tendency to improve the level and quality of life of the urban and rural population, through considering people with disabilities when developing and making suitable the infrastructure, equipment and urban services of population centers, to guarantee their security, free movement and accessibility. Dispositions will be issued for the construction and suitability of infrastructure, equipment and urban services, to guarantee security, free movement and accessibility needed by people with disabilities, establishing the consulting procedures among disable persons over the technical characteristics of projects. Coordination and agreements over actions and investments among public, social and private sectors, will be promoted by the federation, federal entities and municipalities, in order to impel construction and suitability of infrastructure, equipment and urban services that people with disabilities may need. [Title] Health General Law [Issuance Year] 1984, last reform: 2005 [Purpose] Regulates the right to health that all persons have in terms of article 4 th of the Mexican United States Political Constitution. [Description] In this law, the terms invalidity and invalid people are still used referring to disability: Specifies that it is a matter of general healthiness to prevent invalidity and the rehabilitation of invalid people. Government departments and health sector entities as well as governments of federal entities, will promote and support the creation of groups, associations and other institutions having as an objective to organized participate in programs for the promotion or improvement of individual or collective health, as well as for prevention of illnesses, accidents and invalidity, and rehabilitation of invalid people. The Health Ministry and the federal entities governments, will file, produce and process information regarding birth rates, mortality and invalidity. Basic activities of Social Assistance are: I. Attention to people who cannot satisfy their basic requirements for sustenance and development due to social-economical deficiencies or for invalidity problems; II. Attention to minors and elders in abandonment or helplessness conditions as well as invalid people without resources... V. Provide juridical assistance services and social guidance, specially to minors, elders and invalid people without resources; 11

12 12 Attention in what invalidity prevention and rehabilitation of invalid persons is concerned, comprehend: I. Research on the causes of invalidity and factors affecting it; II. Promotion of community participation in preventing and controlling the and factors affecting it; III. Early identification and timely attention to physical, mental and social processes that may cause invalidity; IV. Educational guidance to collectivity in general regarding rehabilitation and particularly to families with invalid members, promoting an effect of social solidarity; V. Integral attention to invalid people, including adequacy of prosthesis, orthosis and functional aids needed; VI. Promotion of urban and architectonic facilities adequacy to invalid people needs; and VII. Promotion of education and training for work as well as the promotion of jobs to people in a rehabilitation process. The Health Ministry will determine the Mexican Official Standards for the whole country concerning invalidity prevention and rehabilitation of invalid people, and will coordinate, supervise and assess their compliance by public, social and private institutions working toward these ends. The Health Ministry and the federal entities governments will promote, in a coordinated way and within their competence environments, the creation of centers and services for the somatic, psychological, social and occupational rehabilitation for persons suffering any kind of invalidity, as well as actions to facilitate availability and adaptation of prosthesis, orthesis and functional aids. Sanitary and educational authorities, when required and within their own competence environments, will cooperate to provide rehabilitation attention. The Health Ministry and the federal entities governments in coordination with other public institutions, will promote facilities for invalid people in those places rendering public services. [Title] Children and Adolescents Rights Protection Law. [Issuance Year] 2000 [Purpose] To guarantee guardianship and respect to fundamental rights of the constitution, for children and adolescents. [Description] Establish as main principles of protection to children and adolescents, among others, equality regardless of race, age, sex, religion, language or dialect, political or otherwise opinion, ethnos, national or social origin, economic position, disability, birth circumstances or any other condition of their ancestors, guardians or legal representatives.

13 13 Federal authorities from the States, the Federal District and Municipalities, within their competence environments, will keep coordination to determine whatever is necessary so children and adolescents with disability, may receive appropriate attention to their condition in order to rehabilitate them, improve their life quality, reincorporate themselves to society and stand them equal before any other person in order to use their rights. Children and adolescents bearing a physical, intellectual or sensory disability may not be discriminated by any reason. Beside all other rights that this law recognizes and grants to them, they are entitled to fully develop their capacities and enjoy a dignified life allowing them to integrate into society, by participating in scholastic, labor, cultural, recreational and economical environments, as measured by their possibilities. The Federation, the Federal District, the States and the Municipalities, within their competence environments, will provide rules tending to: A. Recognize and accept the existence of disability. B. Offer forming and educative aids for parents and relatives of children and adolescents with disability, in order to give them the necessary means so they may encourage their development and dignified life. C. Promote actions among different disciplines for studies, early diagnosis, treatment and rehabilitation of disability of children and adolescents, as needed in each case, securing that these actions be appropriated to the economic possibilities of their relatives. D. Encourage special educational centers and educational projects which could allow children and adolescents with disabilities, to integrate themselves to regular educative systems, as per their possibilities. They will have free elemental care treatments, access to early stimulation programs, health services, rehabilitation, relaxation, occupational activities, as well as work training. Creation of these services will be promoted in case of their inexistence. E. Adapt the surrounding environment of children and adolescents with disabilities, to their particular needs. [Title] Social Assistance National System Law. [Issuance Year] 2004 [Purpose] To provide basis for the promotion of a Social Assistance National System encouraging and coordinating efforts to render public and private social assistance services, as well as impel social participation in these matters.

14 [Description] Provides that people with disabilities or special needs, have the right to social assistance. 14 It is understood that invalidity prevention and the rehabilitation and integration of persons with any kind of disability for a productive and active life, is a basic health service as per social assistance is concerned. The National System for Integral Development of Families will render services of juridical assistance, representation and social guidance to children, adolescents, elder persons and people with any kind of disability, who, for any circumstances, are incapable to fully exercise their rights. [Title] Public Works and Related Services Law. [Issuance Year] 2000, last reform: [Purpose] To regulate actions related to public works planning, programming, budgeting, contracting, expending, executing and controlling, as well as those of related services. [Description] All public facilities should secure accessibility, evacuation and free movement without any architectonic barriers for all persons, and should comply with all design and signaling rules to be issued and applicable to installations, paths, sanitary services and other similar places for people with disability. [Title] Sustained Rural Development Law [Issuance Year] 2001 [Purpose] To promote a sustained rural development of the country, to make propitious an appropriate environment in terms of paragraph 4, article 4, and to guarantee the state governing and its role in promoting equity, in terms of article 25 of the constitution. [Description] The concurrent special program for sustained rural development derived from this law, will promote for all rural communities: gender equity, family protection, women and young people programs encouragement, protection to vulnerable groups with special attention to children, disable people, elders and people with terminal illnesses. For people with disabilities, owners of land or not, programs will be formulated and implemented approaching their own problems and development possibilities, through economic activities which will be assembled by productivity impulse instruments and those of assistance nature, assisted by the basic infrastructure of competent entities. Also, temporary job programs should be available to attend seasonal income of rural families. [Title] Books and Reading Encouragement Law [Issuance Year] 2000 [Purpose] To encourage and promote reading. To promote production,

15 distribution, diffusion and quality of the Mexican book and make it available to population as a whole. [Description] The National Board to Promote Books and Reading will have the function of supporting actions that facilitate the access of disable persons to libraries and to text hearing techniques. [Title] Elder People Rights Law [Issuance Year] 2002, last reform: [Purpose] To guarantee the rights of elder people as well as to provide the basis and dispositions for their compliance. [Description] The law guarantees the right of elder people to be subject to social assistance programs in case of unemployment, disability or loss of sustenance means. The state will provide preferred attention. All public or private institutions rendering services to elders should have the appropriate infrastructure, furniture and equipment to perform alternating procedures in administrative procedures as well as the necessary human resources, in case they present some kind of disability. Health programs directed to watch over the needs of persons in different stages of their life cycle, will incorporate prevention and health promotion measures, in order to prevent disabilities and favor a healthy aging. [Title] Mexican Army Social Security Institute Law [Issuance Year] 2003 [Purpose] To grant benefits and render services conferred by the law. [Description] Establishes rights for the relatives of registered persons, in case they present any disability to work. [Title] Women s National Institute Law [Issuance Year] 2001 [Purpose] Creation of the Women National Institute as a public entity decentralized from the federal public administration. [Description] Subject to the guaranteed rights of this law are all Mexican and foreign women being in the national territory, and those Mexican women in foreign countries, regardless of their ethnic origin, age, marital status, language, culture, social condition, disability, religion or dogma. [Title] Tourism Federal Law. [Issuance Year] 1995, last reform: 2000 [Purpose] To determine the necessary mechanisms for the creation, maintenance, improvement, protection, promotion and exploitation of the national resources and tourist attractions, protecting the social and ecological balance of the related 15

16 places. [Description] To guarantee equal opportunities to people with disabilities within the development, promotion and training programs of the tourist sector. 16 To establish agreements with suppliers of services to determine adequate prices and conditions in order to facilitate trips of people with disabilities. The Tourism Ministry will impel creation and adequacy of tourist infrastructure where needs of people with disabilities will be considered. [Title] [Issuance Year] 2003 [Purpose] Discrimination Prevention and Elimination Federal Law. To prevent and eliminate all kinds of discrimination against any person in terms of Article 1 of the Mexican United States Political Constitution, as well as to promote equal opportunities and treatment. [Description] Discrimination is understood as any distinction, exclusion or restriction that based on disability, among other factors, may have the effect of forbidding or revoking the use of rights or their recognition, as well as real fairness toward people s opportunities. It seeks to promote access to children development centers, including minors with disabilities. Public entities and federal authorities, in their competence environment, will perform, among others, the following positive and compensatory measures in behalf of equal opportunities for people with disabilities: To promote an environment of free access and movement; To procure their incorporation, permanency and participation within the regular educational activities in all levels; To promote at all levels of obligatory education, the granting of necessary technical aids for each disability. To create permanent programs of work training and encouragement to their labor integration; To create adequate recreational places;

17 17 To procure accessibility to public transportation means of general use; To promote that all public constructions or spaces, or those rendering services to the public, should have the adequate physical disposition or signaling for their free movement, access and use; To try that all general communication ways bear adequate signaling to allow free movement for them; To inform and advice construction professionals about requirements to facilitate access and use of properties; To promote that in all units of the national health and social security system, they may regularly receive needed treatment and medication in order to maintain and improve their functional capacity and quality of life. [Title] [Issuance Year] 2005 [Purpose] Federal Law on the Promotion of Activities from Civil Society Organizations. To promote the activities from civil society organizations. To establish rights and obligations of civil society organizations which comply with this law requirements, so they may be subject to the promotion of their activities. [Description] Those activities subject to promotion from civil society organizations, include rendering of services to attend social groups with different capacities. [Título] Mexican Official Standard NOM-001-SSA [Año de publicación] 1993 [Description] Establishes the architectonic requirements to facilitate access, movement and permanency of disability people into medical assistance institutions of the national health system. [Title] Mexican Official Standard NOM-173-SSA [Issuance Year] 1998 [Description] Establishes procedures for the integral attention to people with disabilities in the governmental health system. [Title] Agreement to provide procedures for accessibility of people with disabilities to federal facilities [Issuance Year] 2004 [Description] Provisions of this agreement are compulsory for government departments and entities of the Federal Public Administration, which are users of the Federation properties, having the objective to regulate the design and performance of urban and architectonic elements in order to facilitate access, movement and use of them by people with disabilities, in all internal or external spaces of federal properties where human activity is performed.

18 Legal Framework interpretation and implementation 18 There are at least 14 federal laws with at least one article related to persons with disability, their rights are recognized, facilities are granted, or specific programs benefiting persons with disabilities are issued. Mayor laws as The Federal Labor Law, The Law of the Security Institute and Social Services of State Workers or the Health General Law, which were issued many years ago refer to incapacitated or handicapped persons. Recently issued laws do mention the term persons with disabilities. Although legislation exist on many fields, the lack of regulation for the present laws concerning disability issues impede their effective implementation and monitoring. Each Mexican State (31 in total) and the Federal District (Mexico City), have a law for persons with disability, but only five of them have the necessary regulation. There is the advantage that the persons with disabilities are considered in the text of the First Article of the Mexican Constitution which opens the door to legislative changes and rights. The General Law for Persons with Disabilities has been recently issued. This law shows a medical model, giving the direction of the disability issue to the Ministry of Health. During the elaboration of this investigation we did not find record of cases related to disability carried in front of tribunals. The National Commission of Human Rights does not count on information processed and systematized on the complaints they receive with respect to disability issues. They informed that the information could be requested, but his elaboration surpassed the time established for this investigation. Additionally, the fact that people with disabilities complaints are taken into consideration along with senior citizens cases, another vulnerable groups or another kind of complaints, makes difficult to obtain indicators. The National Council for the Prevention of Discrimination (CONAPRED), an agency of recent creation informed of the complaints received for its conciliation. It is pertinent to mention that 29 % of this complaints are not being monitoring any longer as the complainer has lost interest in the case follow up. The Book Present Overview of the Persons with Disability s Rights The Roll of Mexico Facing International Compromises published by the Human Rights National Commission states Not all disabilities are contemplated just the same by the existent legislation. The people with intellectual and physical disabilities are the group who have more limited their rights since considered juridically incapable. The state envisages the possibility of partial protection of people's with sensorial disabilities, through figures like the right of the deaf persons be to helped by interpreters in legal audiences. But this opportunity is not offered to those who are blind, since the official documents in judgments are not translated into Braille.

19 In general, the Civil Codes define restrictions to juridical personality as: The minority of age, the status of inter-diction and other incapacities established by law; but incapable citizens can exercise their rights or contracting obligations by means of his legal representatives. 19 Few state s laws make reference of whom are incapable. In these cases the legal texts incorporate minors and indicate the persons of legal age with these specific characteristics: a ) The people with lack of or decreased intelligence or distraught of her, although they have lucid interval; and those that suffer any affection originated by disease or continuing deficiency of physical, psychological or sensorial character or for the addiction to toxic substances, like alcohol, psychotropic or narcotic drugs; Provided that due to limitation or the alteration in the intelligence that this provoke them they may not govern to make a commitment for themselves to manifest his will for some mode. B ) The Deaf and or the speech impaired that don t know how to make themselves understood by a written way or by means of a sign language interpreter. In the cases mentioned above the disability is clearly specified: covering persons with mental or intellectual disabilities, deaf persons or persons with speech and language disorders.. It is important for the concept of juristic capability to be able to incorporate aspects and specific characteristics out of every one of disability s types when they may be relevant, as well as comprising the various protective forms that can exist with regard to this matter Management and Organization of Disability Issues 6.1. Director Body In 1995, the "National Program for the Well-Being and the Integration of the Persons with Disabilities CONVIVE" is issued as an official governmental program by the Chief of State, being the head of sector the National System for the Family's Integral Development "DIF." It was based on the UN Standards Rules, and was monitored by the National Coordinating Commission, divided in 8 Working Groups embracing the more important themes like Education, Employment, Health, Communications and Accessibility, Family, among others. Under this program "Offices for the Promotion of Services" where created all over the country. Each Chief of Office was called The Promoter, and where dependant of DIF, disabled persons where chosen for this position and their task was to implement the first governmental programs aimed at the population with disabilities. 1 Comisión Nacional de Derechos Humanos. Panorama Actual de los Derechos de las Personas con Discapacidad, La situación de México frente a los compromisos internacionales. México, 2003

20 20 In December of the year 2000, the President Vicente Fox Quesada, created the Mexican Presidency s Office for the Promotion and Social Integration of Persons with Disability, chaired by a person with disability that was a member of the Presidential Cabinet. This Office was dedicated to planning and coordination of the National Advising Counsel for the Social Integration of the People with Disability ( CODIS ), created in February of the year 2001 by President Fox. CODIS developed plans and projects along with several Ministries. The advisers did not find any indicators or public information regarding monitoring the work of CODIS. In June 10th 2005, ORPIS was annulled along with the CODIS through the publication in the Federation's Official Daily Newspaper of The General Law of the Persons with Disabilities. The aforementioned Law bestows the responsibility of the theme of attention upon the subjects of persons with disability sector, through the Ministry of Health and creates the National Council for Persons with Disability. The Council is chaired by the Minister of Health, and the executive director is the National System for the Family's Integral Development DIF. Nacional para el Desarrollo Integral de la Familia DIF. At the end of this investigation Mexico has not published yet the new Disability Law s Regulation neither created the new National Disability Council. This is a transition period without a clear leadership or organizational chart in the disability field Public Sector Organizations [Name] Ministry of Health National System for the Family's Integral Development DIF Ministry of Public Education Ministry of Work and Social Security Ministry for the [Description] Acknowledge disability like a serious emerging problem of public health and establishes among its lines of actions to strengthen the disability prevention and rehabilitation, considering that the adequate and opportune attention of the same avoids social upsets and problems of family disintegration, illiteracy, unemployment, mendicity and an important economic loss. To Establish and Coordinate the programs for the attention of persons with disability at federal, state and municipal levels with the participation of social organizations, principally through the states commissions or councils that work at the 32 federative entities and the similar created at the municipalities. To Create conditions that permit to assure the access of all the Mexican to an education of quality, in the level and mode that they require and at the place where they demand it. Integration or social re-integration of the persons with disability in productive activities, through the coordination of the different instances of the public sectors, private and social. To develop and coordinate the federal government's social

21 Social Development Minsitry of Communications and Transports Secretaría de Función Pública and subsidiary policies, guided toward the common good, and to execute it in a coordinated fashion along with the society. To support NGOs profesionalization To promote the accessibility to all means of transportation and communication. To promote the accessibility to all Federal Facilities The Roll of Civil Society Organizations. With the aim of initiating an awareness campaign toward the government and the civil society, a bunch of civil organizations appeared in the late eighties (although some already existed), they were formed of disabled children s parents and families, conforming the base for the emerging of organizations leaded by persons with disabilities. A dialogue between government and the civil Society was established in early 90's, with the aim of beginning to break architectonic barriers that have always been the most expensive of eliminating and the most visible at the surroundings. Some businessmen, owners of an important supermarket chain started to hear the organizations, which is why the market of the grocery stores began to be accessible to persons with disabilities and with this, the first steps for the to buy at lest the basic elements for their daily living. Since this businessmen where also owners of a cafeteria chain the persons with disabilities began to assist to them and to know that the path to a more integrated participation was on his way. Libre Acceso A.C. leaded the first parade of local and foreign organizations in Mexico City in 1994, toward the Mexican Congress where the requests of this group were listened to for the first time. The institutions of the civil society have played a fundamental role in the advances that have taken place at the country in the disability field, they are the ones that have pressed the administration for elaboration and implementation of laws and national programs. For a long time they have supplied the scarcity of services for the people with disabilities. There are over 800 organizations to and of persons with disabilities in Mexico addressing the needs of this collective, comprising all kinds of disabilities. However, the bigger concentration and the most representatives are located in the Metropolitan area of the Mexico City. The most representative Associations for the work accomplished at national level are: APAC, A.C. CONFE, A.C. Libre Acceso, A.C.

22 Fundacion Teleton Piña Palmera A.C. Fundacion Langdon Down Mexican Deaf Persons' Federation 22 CONFE is an umbrella organization conformed of families with intellectually disabled children. The main organization in Mexico City works in a business oriented approach training and employing persons with disabilities in different workshops established in their own premises and selling de products to diverse businesses in the area. APAC conforms a national network of affiliated associations. They are specialized in attention to persons with cerebral paralysis. Libre Acceso is an institution from the civil society that has stood out for the sake of eliminating architectonic, cultural and social barriers, promoting the physical accessibility in any kind of constructions, parks an recreational places, urban spaces, public and private transportation for the integration of persons with any type of disabilities. Piña Palmera attends persons with disability in indigenous communities, concentrating his acting in the State of Oaxaca Disability related International Cooperation Actions This activities where found during the present investigation. Might be more in the different States of Mexico. JICA-Mexico APAC, A.C. Mexico City, support for the education of children and teenagers with cerebral paralysis Piña Palmera A.C. Training National Rehabilitation Institute. Medical Training Spain s Blinds National Organizations (ONCE) Resource Center for Blind persons in La Salle University, Mexico City, aimed to integrating young blind persons to college. Inter American Development Bank Funding for Ministry of Labor and Social Prevision s Probecat Program consisting of scholarships for labor training for young and adults with disability. Mobility International USA Support to women with disability from the State of Oaxaca, with empowering and leadership training for young and adults. Access Exchange Internacional Training of Mexico City transportation officials. Consulting in the planning process for accessible transportation.

23 7. Public Policies 23 [Title] National Development Plan [Period] 2000 [Temas sobre Discapacidad] To promote and strengthen the people with disabilities development to put them on the same level and facilitate their full integration in all environments of national life. To impel and promote wider coverage and an improvement over public policies in order to promote social integration of people with disabilities. Institutional programs will be strengthen toward this end through a coordination among secretaries with a follow up and assessment system. Modifications to the juridical frame will be proposed. Civil social organizations participation will be encouraged through application of self-support citizens projects, in order to improve life quality of disable citizens. Also, the national registry of population with disabilities will be formulated. [Policy/Title] Action Program for Prevention and Rehabilitation of Disabilities PreveR-Dis. [Issuance Year] 2001 [Description] To impel and strengthen development of prevention and disability attention programs, through participation of institutions from the three levels of government and civil society as a whole; to reduce frequency of disabilities, support medical rehabilitation of disable people, diminish their disadvantages, improve their functioning and facilitate their incorporation to social and productive life. [Policy/Title] National Accessibility Program [Issuance Year] 2001 [Description] To promote, spread and perform programs having as an objective to achieve adequacy and implementation of public policies over accessibility either physical, in transportation and in communications. [Policy/Title] National Program to Strengthen Special Education and Educative Integration. [Issuance Year] 2002 [Description] This program is directed to guarantee quality educative attention to children and adolescents needing an education. [Policy/Title] Popular Fideprotesis Program [Issuance Year] 2002

24 24 [Description] Instrument of Financial protection to people with any disability who do not enjoy social security benefits. They have the possibility to acquire: prosthesis, orthosis, orthopedic devices and technical aids required to correct any disability and thus improve their health and their performance in society. Consists of an investment and administration trusteeship integrated with contributions from organisms, institutions and government departments which number and amount of contributions will be increasing as the trusteeship widens its coverage range. [Policy/Title] Program to Support People with Disabilities in the rural environment. [Issuance Year] 2003 [Description] To offer integral attention to people with disabilities in the rural environment, mainly to those located in away-from-society zones, to impel their economic, productive, technical and organizing capacities. [Policy/Title] Quality Attention National Program [Issuance Year] 2003 [Description] To sensitize and train the highest number of public workers so they know and perform quality services to people with disabilities, as their physical, intellectual and sensitive conditions require specific attention for their security and efficiency. 8. Information Registry 8.1. Census [Title] National Census on Housing and Population [Year] 2000

25 25 [Issues on Disability] A question on disability type and an enlarged questionnaire (poll) are included for the first time, based on the International Classification of Impairments Disability and Handicaps, and also United Nation s criteria, including the Standard Rules on the Equalizations of Opportunities for Persons with Disabilities.. The Census defined disability as the presence of any physical or mental, permanent or for over six months limitation, that prevent the development of normal activities within the margin that is considered normal for a human being. They obtained demographic and social data, including access to the health services of health and some educational and labor characteristics. The figures obtained in the census have been challenged by the organizations of and for persons with disability. The pollsters lacked the adequate qualification to identify a person with disability, leaving to the polled the decision to define themselves as a persons with or without disability. [Title] Diagnostic of Persons with Disability in Highly Marginalized Territorial Units of Mexico City [Year] 2003 [Issues on Disability] Census developed by the National System for the Integral Development of the Family of the Federal District. Developed specifically to find the characteristics of the population with disability in the poorest area of all the administrative divisions of Mexico City. Included the next questions: Disability Origin Disability by age range Disability type in children by age range Disability type by Administrative Division Most frequent diseases Person with disability that require personal care (by administrative division) Persons that require medical attention or rehabilitation (by administrative division) Institution where they receive medical attention [Title] National Health Survey 2000 [Year] 2000

26 [Issues on Disability] 26 Elaborated by the National Institute of Public Health and the Ministry of Health, included information on housing, population and usage of health services. Among its objectives are estimating the frequency and distribution of positive indicators of health; factors of risk, diseases (acute and chronic), injuries and prevalence, distribution and characteristics of disability in the Mexican population. The survey estimates that there are 2'275,374 persons with disability in the country. The data of National Census of Population of 2000 relating the number of persons with disability in the country does not match neither with the figures of The National Survey of Health 2000, nor with the Census from Mexico City Information obtained visited institutions that have public information or from the ones that answered upon request. Institution Information Human Rights National Commission National Council for the Prevention of Discrimination The National Commission of Human Rights yields advances in the publication and distribution of books and educational brochures, about the disability theme. They mentioned that it was possible to request information on the complaints received on the subject of disability, but the time of answer exceeded the time given for the delivery of results of this investigation. Updated compendium of Laws that include the disability theme. The National Council To Prevent Discrimination, that started operations in 2004 yields 41quejas related with presumed discrimination by disability. Twelve of these complaints have not being monitored due to the lack of interest of the complainers. Definitely presumed discriminatory acts have been seven and they have been resolved during the procedure. First National Survey on Discrimination in Mexico. DIF-DF Number of People's with disability receiving direct subsidy: people Diagnostic of Persons with Disability in Highly

27 Institute for the Administration and Economic Evaluation of National Facilities Mexican Social Security Institute National Institute of Statistic, Geography and Data Processing 27 Marginalized Territorial Units of Mexico City Data on Accessible Transportation Data on actions of urban accessibility. Number of federal facilities diagnosed to date about level of accessibility: of a total of facilities. The diagnosis corresponds to the first phase of the Agreement of Accessibility to Federal Facilities. Indicators on affiliated workers' invalidity and incapacity. Statistical information on diagnosis of invalidity and permanent incapacity of the affiliated workers. Data on disability of workers affiliated to IMSS indicating that there are up to 771, 172 persons with disability in this group, conforming 34 % of the total national population registered in the survey. National Directory of Associations Of and For Persons with Disability. Data from the National Census on Housing and Populations of National Rehabilitation Institute PreveR-Dis National Program National Public Health Institute National Health Survey 2000 Ministry of Communications and Transports Ministry of Social Development And CONAPRED Ministry of Public Education Ministry of Labor and Social Prevision. Direction of Gender and Equity Accessibility Guidelines and Power Point presentations about accessibility programs developed by ORPIS Power Point Presentation of the Program to Promote Access to Aerial Transportation for Persons with Disability. First National Survey on Discrimination in Mexico: Data of the population's perception about discrimination in the country, applied specifically to Elders, People with disability, Indigenous People, Religious Minorities, Women; population's sectors that have historically been discriminated in Mexico. The sampling was people, of whom 594 were persons with disabilities. The National Program for Strengthening of the Especial Education and the Educational Integration Quarterly report of people with disability trained, by disability type from some Mexican state. Awarded companies in of June 2005, by incorporating persons with disability: 25 companies, incorporating 217 persons with disability of total workers. Figures of 2004 from "Abriendo Espacios

28 Program" : statistics of persons with disability attended, evaluated, sent to centers of recruitment and hired via "Chambapar Program". Curses held by "Becate Program". Number of workshops for seekers of job, fairs of job, projects of productive investment and in formal job. Ministry of health Work Report National Health Survey 2000 Non Governmental Organizations Manpower México Resource Center for Blind Persons, La Salle University Association in Favor of Persons with Cerebral Paralysis (APAC, A.C.) CONFE A.C. Libre Acceso A.C. Fundacion Teleton A.C. Comentaron que manejan información sobre personas colocadas en un empleo. Sin embargo, no contaban con información pública que pudieran ser proporcionada para esta investigación. Information requested but no public data available. Information about attended persons 28 Work Report 2004, activities and persons attended in Mexico City Report on activities. Proporcionaron información sobre: 1. Disabilities attended at the CRIT system 2. Total of Attended people 3. Attended people's age range 4. Requests of attention received 5. Requests of attention accepted 6. Number of specialist doctors working at CRIT system 7. Number of technical aids requested (wheelchairs, crutches, etc.) 8. Number of technical aids handed-over 9. Duration of the sessions in accordance with the given treatment 10. Total average duration of the treatments 11. Number of dates by user 12. Users' number that finished their treatment, in relation to the accepted users 13. Future estimated demand of services 14. The users' socioeconomic profile. 15. CRIT's influence area 16. Users average travel time to facility 17. Relation of the users that assisting to school, between the ones that do not assist. 18. Indicators developed to measure the

29 Piña Palmera A.C. Ven Conmigo, A.C. 29 effectiveness of treatments 19. Opinion polls to measure the users' grade of satisfaction 20. Another governmental or civil society institutions they maintain relations or agreements with. Information of activities and persons attended Information requested but no public data available Disclosure and Application of ICF. The Mexican Center for the Classification of Diseases, an agency from the Ministry of Health, is in charge of handling ICF issues. We did not find information on CIF campaigns of diffusion during the present investigation, but we have knowledge of the existence of a promotive group and some efforts to communicate it.

30 30 9. Proposed Indicators The investigation and interviews accomplished to governmental officials, NG0's and private entities gave the overview that Mexico lacks systematized information that permit the necessary elaboration of indicators of impact for a national diagnosis in the disability theme. This situation is applicable so much to governmental dependences implementing since two years ago the programs developed together with ORPIS and the CODIS's working groups, like to the organizations of the civil society providing services to persons with disability, that do not count on systematized information either. Neither exists systematized or public information that allows to answer the indicators proposed in the Investigation Protocol provided by JICA-Costa Rica. The organisms that keep records or databases requested the specific information solicited by this investigation but the time of delivery of the information surpassed the time limit for the delivery of products. In another cases, the available information, if exists, referred to the population attended at Federal District (Mexico City) only, which is not representative of the national situation, for which it was not taken into account. An especial case is the Diagnostic of Persons with Disability Highly Marginalized Territorial Units of Mexico City, developed by DIF-DF. We found that it is the only census aimed at determining persons with disability's real situation, even though comprises only the ones that live in highly marginalized areas. One more time it is necessary to indicate that it is not representative of the national situation. The "First National Survey on Discrimination" of last May is the first effort found in the country about knowing the present-day perception of historically discriminated groups toward this phenomenon. Survey's summary is included in the Appendixes of this document In the next pages we'll show the statistics disclosed by INEGI, obtained from the General Census on Population and Housing 2000.

31 9.1. Persons with Disability s Population Profile, according to the Geography and Data Processing National Institute (Data from the General Census of Population and Housing 2000) Basic Data Persons with Disability in Mexico. Sex Distribution Total 1,795,300 Men 943,717 Women 851,583 Population Distribution by Age group Distribución de la Población por grupos de edad Age groups Total 0 to to and up No specified Population 1,795, , , ,825 15, Population by Age Groups 1,000, , , , , , , , , , and over Not specified Percentage of persons with disability by disability type Motor 45.3 Hearing 15.7 Language 4.9 Visual 26 Mental 16.1 Other 0.7 Percentage by type Motor Hearing Language Visual Mental Other

32 Home where the head is a person with disability 32 Total 711,464 Hombres 501,435 Mujeres 210,029 Homes where de head is a persons with disability 800, , ,000 Homes 500, , , , ,000 0 Total Men Women Education Percentage Distribution of persons with disability 15 years old and above by school level Illiterate 35.5 Primary School Uncompleted 27.8 Primary School Completed 15.6 Secondary School or similar Uncompleted 2.5 Secondary School or similar Completed 7.2 Post basic education 9.3 No specified 2.1 School grade population over 15 years Percentage Illitarate Primary incompleted Primary completed Secondary incompleted Secondary competed Posbasic Not specified

33 33 Population with disability form 6 to 29 years and percentage distribution by age group and sex, attending school or not. Sex Age Total Assisting Not assisting No specified Total Percentage Total Percentage Men 288,195 96, , , ,147 70, , , ,019 18, , , ,129 5, , ,900 2, , Women 216,686 75, , , ,522 55, , , ,962 13, , ,037 4, , ,165 1, , , , , , , ,000 80,000 60,000 40,000 20,000 0 Men Women Assisting Not Assisting Not Specified National Schooling average of persons with disabilities: 3.8 years

34 Labor Economic and No-Economic Participation Rate by sex 34 Economic Participation Rate No-Economic Participation Rate Total Men Women Total Men Women Economic Participation Non Economic Participation Percentage Percentage MEN WOMEN 0 MEN WOMEN Percentage Distribution of employed population with disabilities, according to their working status. Employed population with disabilities 397,183 Dependants a/ 53.6 Independents b/ 35.8 Workers without payment in a family business 6.4 No specified 4.2 a/ Includes employees, workers, day laborers and menial workers. b/ Includes employers and freelancers Source:: INEGI. XII National Census of Population and Housing Distribution according to working status Percentage Dependants Independents Family business workers Not Specified

35 35 Percentage Distribution of employed population with disability, according to their working type, by sex Principal Type of Labor Employed population with disability Men Women Total 397, ,623 95,560 Professionals Technicians Education Workers Artist Officers and Executives Agricultural Laborer Industry Inspector or Supervisors Craftsman and Workers Machinery Operators Assistant, laborer or similar Transport Vehicle Operator Administrative Chief or Supervisor Office Clerk Merchants or Store Clerk Informal Workers Personal Services Workers Domestic Service Security or Protection Related Works No specified Employed population with disability, according to their working type, by sex Percentage Men Women 5 0 Professionals Technicians Education Workers Artist Officers and Executives Agricultural Laborer Industry Inspector or Supervisors Craftsman and Workers Machinery Operators Assistant, laborer or similar Transport Vehicle Operator Administrative Chief or Supervisor Office Clerk Merchants or Store Clerk Informal Workers Personal Services Workers Domestic Service Security or Protection Related Works No specified

36 36 Percentage Distribution of employed population with disability, according to their income level, by sex (measured in quantity of Minimum Wage earned) Income level Employed population with disability Men Women Total 397, ,623 95,560 Do not earn a salary Less than 1 Minimum Wage (MW) More than 1 up to 2 MW More than 2 up to 3 MW More than 3 up to 5 MW More than 5 up to 10 MW More than 10 MW Not specified Employed Disability Population More than 3 up to 5 MW 7% More than 10 MW 2% More than 5 up to 10 MW 4% Not specified 7% Do not earn a salary 14% More than 2 up to 3 MW 15% Less than 1 Minimum Wage (MW) 23% More than 1 up to 2 MW 28%

37 37 Percentage Distribution of employed population with disability, according to their activity sector. Employed population with disability 397,183 Primary Sector 23.8 Secondary Sector 24.5 Tertiary Sector 48.5 Not specified 3.2 Employment by Sector Percentage Primary Sector Secondary Sector Tertiary Sector Not Specified Health Percentage Distribution by disability origin Disability Origin Percentage Birth 19.4 Illness 31.6 Accident 17.7 Advanced Age 22.7 Other cause 1.9 Not specified 6.7 Disability Cause Percentage Birth Ilness Accident Advanced age Other Not specified

38 38 Percentage Distribution of the population with disability according to affiliation to a social security institution. Affiliated 44.9 Not Affiliated 53.9 Not specified 1.2 Population covered by Social Security Percentage Affiliate Not Affiliate No Specified Percentage Distribution of the population with disability according to usage of social security, by institution and gender. Users Conditions Population with disability Men Women Total 1,795, , ,583 Users IMSS ISSSTE PEMEX, SDN, SM SSA IMSS-SOLIDARIDAD Other Private Institution a/ Other Public Institution b/ Not user Not specified

39 39 Affiliates by Institution Percentage IMSS ISSSTE PEMEX, SDN or SM Other The data obtained in the General Census of Population and Housing 2000 (CGPV2000) differ from another statistical data, in particular with The National Health Survey of the same year ( ENS2000 ) and the Diagnostic of Persons with Disabilities Highly Marginalized Territorial Units of Mexico City. The CGPV2000 presents minor numbers than the other ones ( 20 % in relation to the ENS2000 and in a 40 % regarding the population estimated for the D.F, according to the Diagnostic of Highlu Marginalized Territorial Units of the DIF-DF ). The CGPV2000 is considered as unreliable by the organizations of and for persons with disabilities as it proves to be obvious that the data are conspicuously inferior to the reality. The results of the ENS200 related to disability are presented in Appendix Current Situation Health The Ministry of Health in his Work Report of 2004 states that the disability constitutes one of the emerging problems of public health, that in late years has grown constantly as a result of the best resources of diagnosis and treatment of diseases, the increment of life expectancy and the bigger coverage of the health services. It has been managed to decrease the general and infantile death rates considerably, but, frequently, without achieving to avoid aftereffects that cause limitation in functioning of women and men of all the ages, resulting in variable levels of disability. 2 A web portal called Discapacinet has been developed in order to offer information on health services to persons with disability and their families. The training of human resources for the research in disability prevention was encouraged with the support of the National Council of Science and Technology (CONACYT). 3 2 Secretaría de Salud, Informe de labores 2004, 3 PND Presidencia de la República Cuarto informe de ejecución,

40 40 The training of human resources for the research in disability prevention was encouraged with the support of the National Council of Science and Technology (CONACYT). In January 2004, a DIF-CNR agreement was signed to strengthen the benefit of rehabilitative services of high complexity, along with training of human resources and scientific investigation. The National Program of Health through the National Rehabilitation Institute, has a Program of action for Prevention and Rehabilitation of Disabilities, PreveR Dis whose specific objectives are to reduce the disability s incidence, to promote the equity, quality of the services and to provide financial protection to persons with disability. Since it was created in the year 2000, PreveR-Dis 4 envisage the creation of the following indicators : On the subject of disability prevention Disability cases identified in consultation of first time at the National Health System in relation to the total of consultations of first time. Disability cases referred in relation to the total of identified in first time consultation at the National Health System. Disability cases identified in the course of investigation in relation to the total of registered cases. On the subject of rehabilitation Rehabilitated children incorporated to the formal basic education. Rehabilitated people incorporated to the remunerated work, by age and sex. Quality of life. On the subject of financial protection Percentage or number of persons with disability that received financial support of the total that requested it Percentage or number persons with disability that received financial support of the total of notified cases On The subject of quality Grade of satisfaction Index of adequate treatment It is necessary to indicate than we did not find either quantitative or qualitative information on these indicators, since officer from the National Rehabilitation 4 Secretaria de Salud, PreveR-dis, México D.F Secretaria de Salubridad y Asistencia

41 Institute commented that figures are very hard to obtain and the DIF is currently systematizing the information gathered to date. 41 We went to Teleton Foundation to know the information they keep that may contribute to the elaboration of indicators. They provided specific requested information based on the indicators provided in Investigation Protocol. The country has not been able to implement at the National Certificate on Disability a request stated in the Mexican Official Standard NOM-173 SSA on the integral attention of persons with disability. The result regarding disability of the National Health Survey 2000 conducted by the Ministry of Health and the National Institute of Public Health included: 6 It is thought that of the 96,9 million Mexican 2,2 million are disabled (2,3 %). This proportion is bigger the indicated by the XII CGPV2000, reporting a rate of 1,84 persons with disability for each 100 inhabitants. Disability's rate in men (2,5 %) is bigger than in women (2,2 %). The percentage distribution according to type of disability was the following: physical ( 46,6 % ), mental (16,5 %), hearing (16,4 %), visual (14,6 %) and speech disorders (2,2 %).No had important differences for sex of language. To older age, bigger physical, hearing and visual disability proportion, but minor proportion of mental type. Teens were the age range biggest proportion for language disability (4,6 %). Regarding the disability severity 25% think of it as light, 32,7 % moderated, 34,7 % seriously ill and only 3,7% consider it as very seriously ill. The following were disability's proportion of causes: Inborn (24,6 %), acquired by disease (36,1 %), acquired by accident (20,1 %), acquired by advanced age (14,1 %) and acquired by alcohol or drugs (0,7 %). Disability's biggest differences in the proportion of cases by sex and age were observed in the caused by accidents and by alcohol and drugs. Both causes were bigger in men; on the other hand, in the caused by advanced age a bigger proportion in women was observed. This is explicable in part because of women s higher life expectancy. The population factors associated with higher disability rates were: o Economically inactive population on the grounds of health ( 62,0 % ) o Pensioners and retired persons (13,8 %) o Without school instruction (12,5 %) o Illiterate (15 years and older) (11,4 %) o Unsuited to read and to write (age 6 to 14) (5,4 %) o Low income (3.2%) 6 SSA-INSP Encuesta Nacional de Salud Pública del año 2000, Tomo 1 pag76-77.

42 10.2. Education The Ministry of Public Education, along with the ORPIS developed the Program of Educational Integration, that mandates children young people and adults with disability to regular schools. However, the principal problem for the efficacious integration is school s lack of accessibility in the great majority of public and private schools of all the levels throughout the country. The Associations of private and public Universities, are committed to the inclusion of persons with disability, and they are now doing the first changes and studies for this effective integration The Ministry of Public Education has tried to obtain the real number of pupils with disability registered in basic education school being currently engaged in this process. There are 61 Centers and Resources and Information for the Educational Integration (CRIE ) in 25 states and 511 Centers of Multiple Attention in the Quality Schools Program. The reform of the Bachelor's Degree in Especial Education that is offered in the Teachers Colleges, took place in 2000 with the presentation of the new Curriculum of the Bachelor's Degree of Especial Education. Forty-six thousand teachers of especial and regular education from all over the country where trained in inclusive education in Regarding the field of education, the First National Survey on Discrimination found that three out four persons with disability consider that they have less opportunities to attend school that the rest of the population Labor This is one of most developed fields found during this research, even though the real impact's indicators do not still exist. The are inter-institutional cooperation network between governmental agencies and NGOs and private enterprises. The inter-institutional governmental network includes the Ministry of Work and Social Security and his delegations; DIF, DIF branches in each state and the Ministry of Public Education. Several civil organizations cooperate in this network. CONFE Mexico city has its own recruitment agency. The DIF's Agencies of Labor Integration through CHAMBAPAR Program evaluate applicants abilities and skill, setting then his profile and looking for the best job position accordingly. They have attended 7500 persons with disability, of which the 20 % have been placed in a job in the formal labor market. Last year were bestowed training scholarships for persons with disability in order to strengthen their rehabilitation and integration process for the labor market Información obtenida del Programa Nacional de Fortalecimiento a la Integración Educativa del año La información aquí plasmada no ha podido ser ampliada ya que la no fue posible que la Secretaría de Educación Pública proporcionara información adicional para esta investigación, durante el tiempo proporcionado para la misma.

43 43 Goodwill Industries, CONFE and some other NGOs throughout train persons disability for the labor market, providing them with working habits, later on they are sent to the governmental agencies of labor integration or human resources agencies like Manpower Mexico, a private company that have a nationwide labor integration program for persons with disability. It is important to indicate that so much Manpower as the governmental agencies lean on civil associations or at integrative companies to inform about job offers to recruit staff; It is not common to find available job offers for persons with disability in the open market. An Integrative Business Award was implemented this year for the recognition of companies that hire workers with disability. At present the country lacks of national systematized information according to disability type, age, gender or ethnos of persons with disability trained and integrated to a job. The National Fund for Social Enterprises (FONAES) created the governmental program Disabled Entrepreneurs supporting 14 productive projects of persons with disability in 2004 with an amount of 150,000 USD, representing up to 80 percent of the total project budget. The Warranty Fund for Micro-entrepreneurs with disability was created lat year, supporting the establishment of six OASIS grocery stores in the Mexican southeast. The goal for 2006, is to assist one hundred persons with disabilities in the operation and management of the aforementioned stores. 34 articles are free of import taxes, benefiting thirty thousand persons with disability. The Consumer Protection Federal Bureau (PROFECO) held the PROFECO's first persons with disability consumption analysis Forum with 101 assistant. The Ministry of Economy distributed 32 thousand brochures with information about the products and services addressed to people with disability. The program to support persons with disability in rural areas of SAGARPA has distributed program s issues and brochures on offered support. They have funded more than people with disability, with a total investment of 360,000 USD in 486 productive projects from May 2003 to December The projects submitted for support must comply the requirement of having at least six associates and 20% of them being persons with disability. Government of the Mexico City bestows a subsidy upon persons with disability of low income, counting individuals last year, (which would represent 42% of the total of persons with disability that INEGI said live in Mexico City)

44 44 These data throw away as a result two facts key: 1 ) the patronizing focus that keeps prevailing in some government sectors toward persons with disability, in this case, the subsidy granted by the government of the biggest and most important city of the country. 2 ) The figures contrast with reality, since the subsidy really does not get to 42 % of the population with disability of the city, that leaves the numbers presented by the local government in debate, or what's more feasible, shows the wrong data obtained in Population's Census of The Government of Mexico City has not developed indicators yet on the real impact of the subsidy in the life of persons with disability. But DIF officer states that they have noted a bigger participation of persons with disability in his family and community context, as they are subsidy receptor the spend it. They are coming out of their houses and taking part in the decisions on the acquisitions that will be done with the received money. The data thrown by the First National Survey on Discrimination contrast with the work accomplished to date and reported by governmental and non governmental organizations, or at least indicates that has been insufficient due to the magnitude of the requests and the generalized perception. Almost 83 % of the polled persons with disability, consider that the discrimination toward his condition associates with lesser job opportunities, for the fear of the companies in the decrease of productivity. Almost 40% have received less salary than a not disabled persons performing the same task. 42% declared they have been rejected for a job position because of his/her disability. The 22% states that to get a job it is more difficult to them Information and Communication During the development of present it investigation we did not find quantitative information on accessible information technologies or communication. An evident fact is the ignorance of ample sectors of the government and private enterprises on the information needs of the persons with sensorial disability, since accessibility is understood only like physical adjusting to the physical environment. The governmental dependences that emit information in alternative formats are scarce and only issuing these formats of specific documents related with programs for the population with disability, but no general information about other programs or services offered. The INEGI published five brochures about entitled "Characteristics of Persons with Disability, and a book that includes a selection of 81 statistical indicators for each disability type, such as: Hearing, language, mental, physical and visual, by state, derived from the result of the XII General Census of Population and Housing They are not available in alternative format.

45 10.5. Social Security The laws of the Institute of Social Security and Services for the State Workers and the Institute for Social Security of Military Forces still use inappropriate terminology when referring in their texts to "incapacitated people". They envisage the possibility of the rehabilitation of people incapacitated by accidents of work and the right for a pension is recognized incapacitated people when they are dependent insured workers' relatives. In the private sector, the insurance companies do not accept persons with disability if they want to buy a life or medical insurance plan. Persons with disability are only accepted when they are part of a collective contract, usually as a job benefit form the employer. The Mexican Institute of Social Security (IMSS), keep indicators on workers' invalidity and incapacity, from IMSS own workers as from the affiliated companies. The information is available in IMSS web page, along with the next statistical information of labor health. 8 The IMSS' available information does not make reference to the disability as such, it is referred to: Indicators: Invalidity or incapacity Rates Statistical information Invalidity certificate granted by blindness or deafness, cerebral paralysis or another paralytic symptoms Permanent incapacities by risks of work, owed to members' amputation Permanent incapacities by Hypoacustic The National Health Survey indicates that persons with disability declared themselves as IMSS affiliates. We did not find information on labor rehabilitation Accessibility The Mexican Institute of Social Security ( IMSS ), developed in early 90's the first accessibility guidelines that was widely diffused. The guidelines were focused on accessibility for health facilities, embracing also another type of buildings. Later manuals published in the country have been based on this first IMSS Guidelines. The ORPIS presented in 2001 the Accessibility Promotion National Program, focused on accessibility to federal buildings and state funded housing projects. We did not find printed or electronic document containing the text or guidelines of this Program, but the ORPIS' Accessibility Guidelines addressed to general public, and available in the ORPIS' website Página del IMSS: los indicadores se encuentran en la dirección:

46 46 As part of the Accessibility Promotion National Program, ORPIS through the Department of Civil Service elaborated the "Agreement for the Establishment of Accessibility Guidelines for Easy Access of Persons with Disability to Federal Facilities." This Agreement dispositions must be observed by Dependences and Entities of the Public Federal Administration, with the object of standardize the design and execution of architectural elements that facilitate access of persons with disability to indoors and outdoors build environments. The number of federal facilities covered by this agreement amounts , of whom have been diagnosed to date about their current accessibility condition (53 %). Facility diagnostic is the Program's first phase consisting of conducting an evaluation of the facility characteristics and establishing the accessibility needs. There are also subleased federal facilities, which are not covered by this program. 9 Information on already accessible facilities was not provided nor information on facilities being in the process of implementing them. The second one phase involves making suitable accesses to facility's public areas, and the third phase is to make completely accessible all areas. Information of facilities implementing any of these two phases was not provided. Federal Government signed an agreement of collaboration between the Ministry of Communications and Transportations and the private operators of airports and airlines establishing technical guidelines to accessibility for persons with disability allowing them to use installations, equipments and services. Public data on accessible private, state or municipal owned buildings or public spaces do not exist. Available statistics exists upon request from Mexico City Government on the number and placement of curb ramps by administrative division Housing Regarding the item of housing, the governmental housing institute (INFONAVIT) had the policy of requesting that one in each 100 houses should be accessible, but this was only a recommendation and not a mandatory fulfillment. In October 2002 various public and private hosing agencies( CONAFOVI, INFONAVIT, FOVISSTE, SHF, FONHAPO, CMIC, CANADEVI ), subscribed an agreement to promote accessible housing. The result of this agreement is a design guidelines entitled Criteria for the Construction of Adaptable and Accessible Housing developments, specifying 2 types of criteria for the construction of housing. The Guidelines refers to adaptable housing and to accessible housing. These criteria is aimed to satisfy the need of 9 Instituto de Administración y Avalúo de Bienes Nacionales, según información proporcionada para esta investigación.

47 47 physically disabled persons as this type is the one benefiting the most form barrier removal. We interviewed INFONAVIT and CONAFOVI officials, confirming that the guidelines are not a mandatory requirement for housing developments. There is no records in the governmental housing agencies of houses built under the adaptability criteria. We only found records of three accessible houses constructed like part of social programs of housing in a dwelling development located in the State of Veracruz. The constructor considers himself the only person that constructs accessible houses at the country. He also stated that this type of construction is more expensive than a regular house under the present parameters for social housing, and that they require 50% more area than the standard lot in use. It is necessary a greater governmental support he finally added Transport The country lacks systematized information on this item. There are data on the implementation of accessibility features in public and private operated airports of the country. The majority of the airports re accessible, but they do not represent a real impact in the life of the persons with disability, since less than 10% of the travelers in the country have the economic resources to travel by plane, and de number of disability travelers is unknown. During the present research we found that Mexico City, as the biggest and most populated city in the country, is where specific programs on access to urban transportation exist. Only 3% of 175 underground stations are accessible, and only 9% of the total buses Community Based Rehabilitation The country does not have published governmental indicators in this respect. We found that APAC and Piña Palmera are two organizations of the civil society that do apply RBC. Piña Palmera works with indigenous communities in the State of Oaxaca, in rural and marginalized areas. They stated that RBC is the only tool that applicable in the area and that really enables them to take care of the needs of the people with disability in that context. APAC is based on the Mexico City, but it has several affiliated associations throughout the country replying its way of work with people with cerebral paralysis to her, these affiliates apply RBC a well Discrimination The First National Survey on Discrimination, accomplished by CONAPRED and the Ministry of Social Development, shows that the two must discriminated groups in the country are homosexuals and persons with disability. One of the results is that the fist impression of the average Mexican toward persons with disability is "to show consideration" meaning that they feel pity.

48 32,9% of the surveyed persons with disability answered they have suffered an act of discrimination by his condition and 53,4 % answered that they have felt discriminated at work. The perception toward persons with disability is the following: 41% of the interviewees considered that persons with disability do not work so well like the other ones. One third (37%) considered that quality diminishes in school were there are many children with disability. The 42 % was in accord in than once the difficulties of job that you have at present in Mexico were given, it would be preferable to give work the people without disability. 42% agreed that considering how difficult is to find a job nowadays in Mexico, will be preferable to hire persons without disability than disabled ones. The opinions of persons with disability: 4% answered they consider that discrimination exist in Mexico. Over half as much you expressed that they have not obeyed his rights in Mexico to him and a third part said to have been victim of More than half answered that their rights have not been respected and that they have suffered an act of discrimination due to his/her disability in the last year. They feel rejected, and incapable of having an important role in the society Within the family, the victims of discrimination have been one out of three. Half of them is due to issues of tradition or values in its family, and also half believes that is fair that his family discriminate them because of his/her condition Almost half think that they have fewer possibilities of improving his living conditions. Poverty and the unemployment are the bigger suffering of persons with disability. 60%, think that discrimination in Mexico, has increased or remained the same in the last five years. 48

49 11. Conclusions 49 Mexico has a legal framework covering various aspects for the integration of persons with disability, but of an inadequate, obsolete and inefficient way. The New General Law For Persons with Disability is based on a Medical Model rather than a human rights approach. The United Nation's Standard Rules on the Equalization of Opportunities for Persons with Disability have been incorporated in the governmental programs developed recently, but no in the legal framework. The CIF has not had much diffusion and it is only known within the health sector and some related governmental agencies. At present the country is in the phase of implementing the governmental programs developed during the pasts five years. Advances exist, but there is a lack to date of systematized information and the real- impact in the lives of persons with disability. It is clear to notice a country wide need of policies and the clear and effective implementation of governmental programs. During this investigation, we could notice a confusion of responsibilities among the governmental actors implicated, related with programs, agreements and the real needs of persons with disability. The presence of a person with disability in the Presidential Cabinet did not represent for significant advance in the fulfillment of needs of persons with disability. His recent disappearance has only contributed to increasing the confusion and to leave the disability theme of the without a clear and effective leadership. We looked for quantitative indicators regarding attended and working population, persons integrated into regular schools, the need of orthesis and/or artificial members, or at least how many persons with disability belong to poorest sector. It is necessary for the country to count on a reliable national census of persons with disability. The population with disability has felt utilized by other, including Government and even by its own families, using them in excuse to get prebends, electoral votes and resources from all types. There was not a single agency that have developed qualitative indicators on the quality of life or enjoyment and monitoring of the human rights of persons with disability. The population with disability feels discriminated in several aspects of their life, with few opportunities of overcoming. The disability is still seen as a medical, rehabilitative and patronizing theme, but not one of equalitarian integration. Much less as an issue of consumers, public, or partners. The human rights of persons with disability are not being watched nor monitored, nor receiving and adequate treatment in the country.

50 12. Bibliography Documents Elwan, Ann; Dudzik, Pamela y Metts, Robert. Disability Policies, Statistics, and Strategies in Latin America and the Caribbean: A Review. Estudio disponible en la página de Internet del Banco Interamericano de Desarrollo Antúnez, María Eugenia; Balcázar, Andres. Accesibilidad a las Escuelas en México, Situación Actual y Propuesta de Adecuaciones. Secretaría de Educación Pública, México, 2005 Center for International Rehabilitation. International Disability Rights Monitor: Hernández, Marco; et al. Regional Report of the Americas, México U.S.A Comisión Ciudadana de Estudios Contra la Discriminación. La Discriminación en México: Por una Nueva Cultura de la Igualdad. México, 2002 Comisión de Derechos Humanos del Distrito Federal, Compiladora: Dra. Amalia Gamio. Legislación en materia de personas con discapacidad. México 2001 Comisión Nacional de los Derechos Humanos. Panorama Actual de los Derechos Humanos de las Personas con Discapacidad. México, 2003 Comisión Nacional de Fomento a la Vivienda. Criterios de Diseño y Construcción para la Vivienda Adaptable y Accesible. México, 2003 Fridman Mintz, Boris. La Comunidad Silente en México. Texto publicado en Viento del Sur, Núm. 14, marzo 1999, México, DF. Fridman Mintz, Boris. Los Ropajes de la Sordera. México, 2003 Hernández-Licona Gonzalo. Disability and the Labor Market: Data Gaps and Needs in Latin America and the Caribbean. Estudio disponible en la página de Internet del Banco Interamericano de Desarrollo. Instituto Mexicano del Seguro Social. El IMSS en Cifras. Discapacidad en Derechohabientes del IMSS, Resultados Encuesta Nacional de Salud México, 2004 Montes, Andrés y Massiah, Ernest. Disability Data: Survey and Methods Issues in Latin America and the Caribbean. Estudio disponible en la página de Internet del Banco Interamericano de Desarrollo.

51 Presidencia de la República. Plan Nacional de Desarrollo, Informe de Ejecución 2004 Secretaría de Agricultura, Ganadería, Desarrollo Rural, Pesca y Alimentación. Programa de Apoyo a Personas con Discapacidad en el Medio Rural, México 2002 Secretaría de Agricultura, Ganadería, Desarrollo Rural, Pesca y Alimentación. Memoria, Encuentros Regionales de Grupos Prioritarios México, 2003 Secretaría del Trabajo y Previsión Social, Dirección de Equidad y Genero. Memorias, Primer Encuentro de Rehabilitación en el Trabajo México, Septiembre 2003 Secretaría de Salud. Cuarto Informe de Labores 2004 Secretaría de Salud. Programa Nacional de Salud Secretaria de Salud. Programa de Acción para la Prevención y Rehabilitación de Discapacidades PreveR Dis Secretaría de Salud, Instituto Nacional de Salud Pública. Encuesta Nacional de Salud

52 12.2. Interviews 52 Persona Institución Puesto/Área Paulina Alcaraz Manpower Mexico Chair of Let s Walk Together Program Ángel Arvizu DIF Officer Alexi Asatashvilli Comisión Nacional de Derechos Humanos Director for NGO s and Vulnerable Groups Francisco Mexican Presidency s Officer Cisneros Rivero Office for the Promotion and Social Integration of Alejandro Diez Barroso Persons with Disability Federal District Legislative Assembly PAN Party Chief of Adviser at Federal District Legislative Assembly Mercedes Ministry of Labor and Direction of Gender and Equity Estrada Social Prevision Boris Fridman Mexican Deaf Federation President Amalia Gamio National Council for the Prevention of Discrimination Chair of the Programs for the Advocacy of Rights and Dignity of Persons with Disability Enrique Garrido Asociación Pro Personas con Parálisis Cerebral A.C. Director of Teaching, Research and Institutional Affairs Jorge González Institute of the National Projects Management Luis Guillermo Ibarra Ibarra América Larrainzar Verónica Maldonado Gabriela Martínez Alejandro Parodi Carlos Pérez Gabriela Rojo Fund for Worker s Housing National Rehabilitation Institute Ministry of Agriculture, Rural Development, Fisheries and Food Mexican Federation of Organizations in Favor of Persons with Intellectual Disabilities. TELETON National System for the Family s Integral Development, DIF National Commission on Housing Development General Director Persons with Disability General Director Assistant CRIT Edo. De México Subdirector General de Asistencia e Integración Social del DIF Nacional Director of Standards and Building Technology Ernesto Rosas ORPIS Legal Director Dení Salazar National System for the Operative Officer of the

53 Esther Serafín de Fleischmann Rita Solís Elkan Sorsby Family s Integral Development, Mexico City Branch Libre Acceso A.C. National System for the Family s Integral Development Bracsa de México, S.A. de C.V. Promotional Council for the Integration of Persons with Disability Department of Rehabilitation and Social Assistant Director Carlos Velasco INFONAVIT Officer Ligia Veloz National Employment Officer System 53

54 13. Appendix 1, Results regarding disability from the National Health Survey

55 55

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61 61