A welfare home for disabled children at Batu Gajah recently went under fire for inhumane treatment after viral photos of special needs children kept in what seemed like cages circulated on social media.

The chairman of RKKKC Batu Gajah has since responded to the allegations about the welfare home’s practice and said the reasons were mainly for the safety of the children as some of the inmates suffer from more severe mental conditions and can sometimes turn aggressive. According to Sivalingam, the mentally challenged residents were only separated into special cubicles during meal times and sleeping times to avoid inconveniences towards the other residents. However, despite the home’s good intention to implement these cubicles as a safety precaution, there are better methods to improve the facilities in these welfare homes without raising questions on human rights.

Out of 47 residents at Rumah Kebajikan Kanak-Kanak Cacat (RKKKC), 10 are mentally challenged. (Image: The Star)

So what could have been done better?

Women, Family, and Community Development Deputy Minister Datin Paduka Chew Mei Fun said caregivers at these homes need to undergo proper training. “Because they don’t have any training, the easy way out was to lock the aggressive residents in the cubicles without any consultation of medical experts,” she said. Chew agreed that the lack of proper training among the welfare home’s manager and caregivers was one of the weaknesses overlooked by the Community Welfare Department.

The Women, Family and Community Development Ministry has advised the home to carry out thorough psychiatric evaluation for all its residents to check their mental condition and find the best medical treatment. “There is no need to place them in cubicles if they can be less aggressive with medication, or if the doctors recommend that the residents need to seek treatment at Hospital Bahagia. If indeed doctors recommend that some aggressive residents need to be confined, then we need to come up with a better method,” Chew added. The Ministry will send psychiatrists and specialists to the welfare home to assess the condition of its residents. Chew also expressed it is important to address negative perceptions the public might harbor about care facilities for the mentally impaired.

In light of this matter, the National Early Childhood Intervention Council (NECIC) has revised and reissued guidelines for all residential homes for children with disabilities:

Quality of care givers

  1. Care givers should work a maximum of eight hours a day. This is to minimise staff fatigue and potential abuse of children who are difficult to manage.
  2. Care givers should be specifically trained in child development and disability management in order to meet the needs of these special children.
  3. Children should be placed in small groups according to their abilities with sufficient numbers of consistent, interactive care givers who have long-term relationships with the children in their care.
  4. The minimum care giver to child ratio should be one adult staff to five children with disability.

Medical Health

  1. Before being admitted to the residential home, all children with disabilities (residents) should be required to have a complete documented health evaluation signed within the last six months by a licensed health care professional, preferably a paediatrician.
  2. Parents or guardians should be required to provide the residential home with a health history, which includes the child’s previous illness, immunisation record, prior surgery, injuries, known allergies, present state of health, current medical problems and medication.
  3. The residential home should keep a record of all emergency contacts (phone numbers and addresses) for all children.
  4. Care givers at the residential home should have a plan to handle medical emergencies, be trained to give first aid (this should include management of fits, choking, basic life support, etc).
  5. Care givers at the residential home should be responsible for the safe storage and administration of medications to these children.
  6. The residential home should be responsible to ensure that the children receive periodic health checks and specific medical follow-ups.

Rehabilitation & Education

  1. Every child at the residential home should have a written individual education and rehabilitation program, which is reviewed yearly. This should include the physical, emotional, social and intellectual areas of development with the aim of achieving the greatest degree of self-reliance and social integration possible.
  2. If the residential home is unable to provide for the child’s educational needs, children at the pre-school age should be enrolled in an early intervention centre and children who are of school age should be enrolled in a suitable educational system/setting.

As a registered coalition of parents, therapists and professionals from a large variety of NGOs, the NECIC aims to promote early childhood intervention and services for children with disabilities. The council is concerned that many residential homes for children with disabilities are poorly managed, have potentially serious hazards and are not conducive for the development and well-being of these children.

“Perhaps this is a wakeup call for the Community Welfare Department to check all institutions in the country,” NECIC President Dato’ Amar Singh said. “Caging is considered a very extreme measure that developed nations won’t use. Due to lack of resources, we see some local NGOs restrain, tie up and cage their residents. Even Hospital Bahagia doesn’t lock up their patients, unless they are criminals.This shows that the homes’ facilities lack proper setup and the right staff despite having good intentions,” he added. Chew ensured that Welfare Department officers will conduct regular spot checks at all welfare homes to ensure that residents are not being mistreated.

Amar believes that Malaysia has sufficient resources to solve this issue, and the public has also been very generous in helping with funds and bringing in more resources.

Another crucial problem that RKKKC Batu Gajah faces is the high employee turnover rate, which made it difficult for the home to conduct proper staff training. Many caregivers see it as a temporary job and quit once they find jobs that pay better. “The general perception here is that social workers are not well-paid. But in countries like Australia, social and welfare workers are highly paid and revered,” Amar explained. “The key issue is we need to change people’s mindsets and move forward. People with special needs may be difficult to manage, but with proper psychiatric and paediatric care, the situation can improve."

Richard Cheah, a trustee at Pusat Penjagaan Kanak-Kanak Cacat (PPKKC) Taman Megah, a home with over 120 residents and more than 30 employees, also believes in the importance of providing the right condition and environment for children with special needs. “It is normal for the children to get upset when they are bored, or frustrated or hungry,” Cheah said. Whenever they start acting up, the caregivers would take them aside or bring them into the office and communicate with them nicely. “You will be surprised, disabled children can be very intelligent and obedient when they feel comfortable with you. Don’t isolate them,” he added.

Yong, who is a parent to children with autism, urged welfare homes to equip themselves with better understanding on how to handle mentally challenged people because not all cases are the same. “They should check with professionals on what needs to be done before implementing such drastic measures,” he said. “Mentally challenged people are not ‘challenged’ 24/7, only when triggered or agitated.”

Another father who has a 22-year-old with Down Syndrome also agrees that there are different degrees of severity and each person’s requirement is different. “There is no ‘one-size-fits-all’ when it comes to caring for mentally challenged people. You must enter their world and you will know better.”

Nevertheless, it is easy to pass judgements as outsiders because most people don’t interact with these special needs children day and night. Sivalingam welcomes members of the public to visit RKKKC in Batu Gajah and give suggestions on how they can improve the facilities. This also gives the NGO a chance to explain the situation better to people. “It was good that this issue was raised because it helped us to alert the people about welfare for special needs people and the urgency of the matter,” Sivalingam expressed.

RKKKC Batu Gajah has also decided to organise a charity food and funfair to raise funds for the home. There will be special presentations by the children as well as performances by the public. If you are interested to contribute or participate in any manner, here are the details of the fundraising event:

Date: 27 November 2016
Time: 9am to 1pm
Venue: Rumah Kebajikan Kanak-Kanak Cacat Negeri Perak, JKR 511, Lorong Aman, P.O.Box 14, Perak, 31000 Batu Gajah, Malaysia
Phone: +605-365 6197

What are your thoughts on this matter? If you have any suggestions that could help improve, do comment below!