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CBR may be defined, according to three United Nation Agencies, ILO, UNESCO, and the WHO, as a "strategy within community development for the rehabilitation, equalization of opportunities, and social integration of all people with disabilities. CBR is implemented through the combined efforts of disabled people themselves, their families and communities, and the appropriate health, education, vocational and social services" (WHO, 1994) Click me for a more complete description. It differs from Independent Living in that, according to Lysack (1994), the entire community is the target of CBR programs;.the CBR model is one of community development or partnership; IL ideology places control squarely with disabled consumers.
The United States builds the best rehabilitation institutions
in the world. People don't live in institutions though; they live
in their community. They should be rehabilitated (or habilitated)
in their community by and with people in their community. This
page is dedicated to the proposition that rehabilitation is too
important to be left to professionals.
The purpose of this web page is to facilitate the worldwide exchange of CBR information. By sharing this information I expect to learn of methods or programs in developing countries, that may be beneficial in the rural southwest USA. Please tell me what CBR programs you think have practices or methods that could be replicated in the USA. As an example, in one country there is a CBR program in which people travel from village to village to put on a puppet show that conveys the message that pregnant woman should not drink alcohol as that may cause birth defects. In the Southwest USA, particularly with Native American Indian populations, we have a high incidence of Fetal Alcohol Syndrome (FAS). Perhaps a "puppet show" type program can help prevent developmental disabilities in the USA. I would like to hear your ideas.
You can learn more about me by visiting my Homepage at http://www.GenosPlace.org (everyone loves the photo galleries). I can also be reached at:
Gene R Rodgers
1941 Gaston Place
Apt. 122
Austin, TX 78723
phone: 512-929-7776
Email: Geno@GenosPlace.org
I would also like to hear your thoughts on:
I have included two pdf files you can download. The first file
compares CBR with Independent Living. The second describes an
early intervention program called Portage. You will need Adobe
Acrobat 3.0 to read these files. If you don't have Acrobat you
can download it free from http://www.adobe.com/prodindex/acrobat/readstep.html
The following two files are chapters from the report I wrote about CBR.
If you have technical problems downloading or opening these
stories, please let me know Geno@CBRresources.org
http://cbrresources.org/Bangladesh.html
SARPV-Bangladesh
1/2, Kazi Nazrul Islam Road
Block-G, Lalmatia, Dhaka-1207 Miling: G.P.O. Box : 4208
Dhaka - 1000, Bangladesh
Email: shaque@bd.drik.net
Phone 880-2-819271
FAX 880-2-819774
Executive Director - Shahidul Haque
The organization known as SARPV (Social Assistance and Rehabilitation
for the Physically Vulnerable) was formed on the 17th April, 1988.
The field level activities started in 1991 with a skill training
center for the orthopeadically disabled persons at Mohammadpur
of the capital city. Necessarily it is a social product. Realization
of disabled persons themselves during their pursuit of education
and job in the existing reality gave rise to a movement named
SARPV.
http://www.healthwrights.org
HealthWrights
964 Hamilton Ave
Palo Alto CA 94301
USA
Phone (415) 325-7500
Fax: (415) 325-1080
Email: office@healthwrights.org
HealthWrights is a non-profit organization committed to advancing the health, basic rights, social equality, and self-determination of disadvantaged persons and groups. We believe that health for all people is only possible in a global society where the guiding principles are sharing, mutual assistance, and respect for cultural and individual differences. David Werner, a founding member of HealthWrights, helped develop many CBR programs, including Project PROJIMO, and is author of "Where There is No Doctor", which has been translated into 83 different languages. See the books David has authored or co-authored.
URGENT
May 9 2008
Dear friends of PROJIMO and HealthWrights,
It is with deep sadness that we share with you the news that Marcelo Acevedo
died on May 7. The cause of death was brain cancer.
Marcelo was one of the founders of PROJIMO and worked with the program as a
brace and limb maker for over 20 years.
Please read more about Marcelo and a plea for his family. Marcelo
PROJIMO
http://www.projimo.org.mx/
Email: projimo@gmail.com
Calle Constitución s/n (sin número)Col. Las Huertas Coyotitan
Sinaloa México
International Phone 01(52) (696) 96 20115
In Mexico 01(696) 96 20115
The general objective of P.R.O.J.I.M.O. is to help persons with disabilities,
for the purpose of recovering their dignity as human beings and at the same
time, fighting for their rights and the rights of other disabled people to be
integrated or reintegrated into the society. We are a small organization and
community dedicated to improving the lives of the disabled people in need.
http://meds.queensu.ca/icacbr/index.html
ICACBR (International Centre for the Advancement of Community
Based Rehabilitation)
Queen's University,
Kingston, Ontario, Canada
K7L 3N6
Tel: 613-545-6881
FAX: 613-545-6882
Email: icacbr@post.queensu.ca
The International Centre for the Advancement of Community Based Rehabilitation (ICACBR) is an organization committed to advancing the concept and practice of community based rehabilitation in partnership with persons with disabilities and their communities around the world. All ofICACBR's activities are directed towards achieving excellence in education, research and service delivery in community based rehabilitation internationally.ICACBR has helped develop CBR programs in several countries and has published a compendium on CBR programs.
http://www.healthlink.org.uk
Healthlink Worldwide (formerly AHRTAG)
Farringdon Point
29-35 Farringdon Road
London EC1M 3JB
United Kingdom
Phone: 011-44 171 242 0606
Fax: 011-44 171 242 0041
E-mail:
general enquiries: info@healthlink.org.uk
publications: publicatons@healthlink.org.uk
Victoria Richardson richardson.v@healthlink.org.uk
Healthlink Worldwide (formerly AHRTAG) has an extensive collection of CBR materials and publishes a CBR newsletter. Healthlink Worldwide works with more than 30 partner organizations in developing countries including governments, non-governmental organizations and academic institutes to run programs to support particular health needs. These include continuing education and training for health workers in Africa and the Middle East, AIDS and Sexual Health, Child Health and Disability.
http://cbrresources.org/Bangladesh.html
Bangladesh CBR
SARPV-Bangladesh
1/2, Kazi Nazrul Islam Road
Block-G, Lalmatia, Dhaka-1207
Miling: G.P.O. Box : 4208
Dhaka - 1000, Bangladesh
Email: shaque@bd.drik.net
Phone 880-2-819271
FAX 880-2-819774
To establish people with disabilities as an economic, social and a political force, the organization known as SARPV (Social Assistance and Rehabilitation for the Physically Vulnerable) was formed on the 17th April, 1988. The field level activities started in 1991 with a skill training center for the orthopeadically disabled persons at Mohammadpur of the capital city. Necessarily it is a social product. Realization of disabled persons themselves during their pursuit of education and job in the existing reality gave rise to a movement named SARPV. I have been in contact with the Executive Director - Shahidul Haque and am confident, that under Shahidul Haque's leadership, this CBR program will do quite well.
http://dag.virtualave.net
The UNDP Disability Action Group promotes Community-Based Rehabilitation
(CBR) and the inclusion of disabled people in mainstream programs
concerned with sustainable human development.
http://thecity.sfsu.edu/wmc/
Wheeled Mobility Center, International Wheelchair Program
The Wheeled Mobility Center is the communications hub of the Whirlwind
Wheelchair Network of independent wheelchair-producing workshops
in developing countries. Founded in 1989, the Wheeled Mobility
Center (WMC) is dedicated to creating wheeled technology that
maximizes the quality of life for people throughout the world.
For more information send email to: whirl@sfsu.edu
http://www.egr.msu.edu/~haddow/sig17
SIG 17,is a Special Interest Group of RESNA. It provides a forum
for persons who are actively interested in providing appropriate
rehabilitation technology and services to people in third world
and other limited-resource countries.
SIG 17's current focus is on a project named Project Sorebutts.
The aim of this project is to address the problem of pressure
ulcers as they affect individuals in developing countries. We
are also beginning a thrust in Alternative and Augmentative Communication
in developing countries. If you'd like to become more involved
with SIG 17, or simply receive more information, please EMail
Janet Bednarczyk at jbed@unixg.ubc.ca
http://www.escape.ca/~dpi/
Disabled People's International
101 - 7 Evergreen Place, Winnipeg, Manitoba, Canada R3L 2T3
Phone:(204) 287-8010 Fax:(204) 453-1367 TTY:(204) 284-2598
E-Mail: dpi@dpi.org
Disabled People's International (DPI)
The purpose of DPI is to promote the Human Rights of People with
Disabilities through full participation, equalization off opportunity
and development. DPI is a grassroots, cross-disability network
with member organizations in over 110 countries, over half of
which are in the developing world. DPI is administrated through
the headquarters in Winnipeg, Canada and through eight Regional
Development Offices. DPI has consultative status with the ECOSOC,
UNESCO, WHO, and the ILO, and has official observer status at
the United Nations General Assembly.
http://www.ppcd.org
People To People Committee on Disability
PO Box 18131
Washington D.C. 20036
email: webmaster@ppcd.org.
People to People Committee on Disability (PPCD)
Welcomes questions about all forms of international disability
information. A non-profit organization working outside of government
to promote international understanding and communication.
http://www.rehab-international.org/www_rehab-international_org.html
Rehabilitation International
President and Secretary General
25 East 21st Street
4th Floor
New York, , NY 10010
Phone: (212) 420-1500 (Voice)
Rehabilitation International (RI) is a federation of national,
regional and international organizations and agencies working
to promote the prevention of disability and the rehabilitation
of disabled people throughout the world. RI is currently composed
of 135 organizations leading disability prevention and rehabilitation
service development in 81 nations in all the world's region. RI
provides comphrehensive and varied publications on disability
issues, policy, projects and research.
http://www.miusa.org
Mobility International USA and the National Clearinghouse on Disability
and Exchange provides information and resources on a wide variety
of international exchange opportunities for participants with
disabilities and international program coordinators. Some staff
do not respond to email or phone messages.
http://hermes.ecn.purdue.edu:8001/http_dir/Gopher/agen/ABE/Extension/BNG/plowshare22.html
Directory of Rural Assistive Technology Resources. The purpose
of this directory is to provide a listing of resources, services,
agencies, and programs that serve farm and rural families with
disabilities.
http://www.un.org/ecosocdev
United Nations economic and social development and disability
issues
http://ourworld.compuserve.com/homepages/DAA_ORG
Disability Awareness in Action
11 Belgrave Road
London SW1V 1RB
United Kingdom
Tel: +44 171 834 0477
Text Tel: +44 171 821 9812
Fax: +44 171 821 9539
E-mail: DAA_ORG@compuserve.com
Disability Awareness in Action (DAA) is a collaborative project between Disabled Peoples' International, IMPACT, Inclusion International and the World Federation of the Deaf. It is a charitable company limited by guarantee and incorporated in England in January 1992.
http://www.pcs.mb.ca/~ccd/
Council of Canadians with Disabilities
926-294 Portage Avenue, Winnipeg, MB
e-mail to ccd@pcs.mb.ca
CCD Believes in:
Citizenship - Persons with disabilities hold the same rights and
responsibilities as other Canadians. Barriers to our participation
discriminate against us and must be removed., Self Determination
- As full citizens, we assert our right to direct our own lives
and make our own decisions. Consumer Control - We must be centrally
involved in the decision making processes that affect our lives.
Equality - The Charter of Rights and Freedomsguarantees equal
benefit and protection of the law and prohibits discrimination
based on physical or mental disability. All other legislation
must be brouth into line with the Charter.
gopher://veronica.psi.net:2347/7-t1%20%20?disability
Veronicas Disability Gopher
gopher://sjuvm.stjohns.edu/11/disabled/
St Johns University Rehabilitation gopher server
gopher://val-dor.cc.buffalo.edu/11/.naric/.abledata/
National Rehabilitation Information Center's ABLEDATA Database
Information on the ABLEDATA Database; Top 10 ABLEDATA Searches;
NARIC Fact Sheets; and ABLE INFORM BBS File Areas can be found
here.
Some of these NGO"s have web sites but I didn't find the sites very helpful.
http://www.PAHO.org/
Alcida Peréz de Velásquez, M.D.
Regional Advisor in Rehabilitation
Pan American Health Organization
World Health Organization
525 23rd Street, N.W.
Washington, D.C. 20037-2895
Tel (202) 974-3216
Fax (202) 974-3641
email: Perezalc@PAHO.org
PAHO was created in 1902. A regional voice of the World Health
Organization (WHO), it promotes and coordinates the efforts of
its 38 member-countries throughout Latin America and the Caribbean
in combatting diseases and fostering physical and mental health.
Note: their web page is not user friendly but I met with Dr. Alcida
Peréz de Velásquez and found her to be most helpful
regarding CBR books, training manuals, and technical assistance.
Dr. Sandra Land was also very helpful with indigenous populations
in America.
The ILO, together with UNESCO and WHO, is providing technical support to one CBR programme in Ghana. For further information about the CBR programme there, contact:
Mr. Kumah, CBR Programme Manager
Department of Social Welfare
PO Box M.230
Accra, Ghana
The Ghana programme is also benefitting from support provided by a Norwegian NGO, NAD. For further information about NAD support to CBR programmes in Ghana and other countries please contact:
The Norwegian Association of the Disabled
PO Box 9217 Vaterland
0134 Oslo 1
Norway
e-mail: lissen.bruce@nad.msmail.telemax.no
Another important NGO supporting CBR programmes is AIFO. For more information
contact:
http://www.aifo.it/english/
Dr. Sunil Deepak
AIFO
Via Borselli, 4
40135 Bologna
Italy
e-mail: info@aifo.it
Specific link to the pages related to CBR are:
(1) CBR reousce materials are at http://www.aifo.it/english/resources/online/books/cbr/cbr.htm
(2) online learning courses about CBR are available on http://www.aifo.it/english/resources/online/courses/online_courses.htm
(3) Asia Pacific Disability and Rehabilitation journal that devotes lot of
attention to CBR is on: http://www.aifo.it/english/resources/online/apdrj/journal.htm
AIFO: the full name is 'Amici di Raoul Follereau' and is an italian NGO. It
started in 1961, primarily to support Italian missionaries active in the developing
countries for helpting leprosy affected persons. In late seventies and early
eightees, AIFO decided to become more secular, started collaborating with Governments
and international organisations of United Nations. Gradually with availability
of better treatment opportunities for leprosy affected persons, the projects
supported by AIFO became integrated in primary health care services. At the
same time, the projects having rehabilitation services for disabled leprosy
affected persons were opened to all persons with a disability. In 1988, AIFO
started collaborated with WHO for CBR programs. Note: Dr. Deepak has been very
open to sharing information.
WHO is the UN Agency promoting and assisting the inclusion of CBR as part of primary health care. For further information please contact:
http://www.who.int/disabilities/cbr/activities/en/index.html
Dr Federico Monteiro, Chief (may be retiring soon)
Rehabilitation Unit
WHO
CH 1211 Geneva 27
e-mail: DAR@who.it
UNESCO is the UN Agency promoting and assisting the inclusive education of children with special needs in the classroom, and also in a CBR context. For further please see: Inclusive Education
? , Chief
Special Needs Education
Division of Basic Education
UNESCO
7, place de Fontenoy
75352 Paris
France
e-mail: r.wabuge-mwangi@unesco.org
The ILO is the UN Agency promoting and assisting vocational skills acquisition and work opportunities for youth and adults with disabilities within CBR programmes. To obtain ILO publications email: pubvente@ilo.org
For ILO related information on CBR, you may wish to contact:
http://www.gladnet.org/
Carl Raskin
GLADNET Executive Director
Box 612 Station "B"
Ottawa, Canada
K1P 5P7
tel: 613 825 6193
fax: 613 825 2953
e-mail: info@gladnet.org
GLADNET, the Global Applied Disability Research and Information Network is an initiative of The Vocational Rehabilitation Branch of the International Labour Organization (ILO), a specialized agency of the United Nations, with headquarters in Geneva, Switzerland. The Vocational Rehabilitation Branch is responsible for promoting the ILO Convention 159 Concerning Vocational Rehabilitation and Employment (Disabled Persons) 1983.
GLADNET has now been constituted as an independent association, with close links to the ILO.
Dr. Maya Thomas
J-124, Ushas Apts
16th Main, 4th Block, Jayanaagar
Bangalore - 560 011 India
Telephone and FAX: 91-80-6633762
Dr. Thomas was formerly working with ActionAid and is now a consultant
on planning and management of CBR programs. She is also the Editor
of Asia Pacific Disability Rehabilitation Journal.
This link has some good CBR books: http://web.syr.edu/~thechp/multint.htm
The Center on Human Policy (CHP) is a Syracuse University based
policy, research, and advocacy organization involved in the national
movement to insure the rights of people with disabilities. Since
its founding, the Center has been involved in the study and promotion
of open settings (inclusive community opportunities) for people
with disabilities.
Community Based Rehabilitation.
ISBN 0-7020-1941-0
London: Saunders, 1997, written by Peat, M.
Books available through HealthWrights, 964 Hamilton Ave, Palo Alto, CA 94301 or through the Hesperian Foundation, 1919 Addison St, Suite 304, Berkeley, CA 94704-1144 ...Phone 510-845-4507
Disabled
Village Children
ISBN 0-942364-06-6 by David Werner
Contains information on common childhood disabilities including
polio, cerebral palsy, juvenile arthritis, blindness, and deafness.
Provides ideas for rehabilitation at the village level and instructions
on how to make low-cost aids.
Helping
Health Workers Learn
ISBN 0-942364-14-7 By David Werner and Bill Bower
Indispensable tool for health educators. Provides learning activities
for more effective and enjoyable education including theater,
drawing, flannel boards, and other low-tech teaching aids.
"Where There Is
No Doctor - a village health care handbook"
ISBN 0-942364-01-3 by David. Werner, this book has been translated into 83 languages.
Where
There Is No Doctor is perhaps the most widely used health care manual in the
developing world. Using simple language and hundreds of drawings, the book provides
information about recognizing, treating, and preventing common illnesses and
injuries.
Nothing
About Us Without Us
by David Werner. Developing Innovative Technologies For, By
and With Disabled Persons. Utilizes disabled persons as leaders
in the problem-solving process. Our objective is not to catalogue
a set of aids and equipment to be copied, but to share an EMPOWERING
PROBLEM-SOLVING APPROACH. I have this book and highly recommend
it to anyone working on appropriate technology in developing countries.
Questioning
the Solution
by David Werner and David Sanders. Questioning the Solution analyzes
why 13 million children still die every year from preventable
causes, and challenges conventional Primary Health Care and Child
Survival strategies. Too often, health and development planners
try to use technological fixes rather than confront the social
and economic inequities that perpetuate poverty, poor health,
and high child mortality.
-----------------------------------------------------------------------------------------------------------------------------------------
"Prejudice and Dignity" by E.Helander This book introduces readers to the concept and experience of community-based rehabilitation (CBR), Published by: United Nations Development Programme, Division for Global and Interregional Programmes New York 1993..Phone the UN bookstore 212-963-7680. Dr Helander is the head of the Interregional Programme for Disabled People of the United Nations Development Programme.
"Sharing Opportunities - A Guide to Disabled People's
Participation in Sustainable Human Development" by E.
Helander. Published by: United Nations Development Programme Disability
Action Group Geneva 1996
---------------------------------------------------------------------------------------------------------------------------------------
Essential CBR Information Resources
This book lists 118 resources, including books, articles, manuals,
reports and videos. It contains a brief description of their contents
and how to obtain them. It is available for $10 US from AHRTAG
(see web sites)
Disability and Self-directed Employment: Business Development
Models
ISBN 1-896691-21-8
A. Neufeldt and A. Albright, Eds. (1998)
The idea of wage employment as the only real goal for disabled people is starting to be challenged by another idea -- self-directed employment. In low-income countries there has never been many options due to low wage scales. With relatively little access to salaried employment, and the only real safety net being one's family, other means of income generation have been important for the survival of significantly disabled people. In high- income countries, however, the situation has been different. For a variety of reasons, policies related to the employment of disabled people have focused almost exclusively on issues relevant to accessing wage employment; as has the attention of organizations concerned with disabled persons. Only within the past few years are we beginning to see increasing interest in self-employment, and other entrepreneurial options where disabled people may be in the lead role.
This book is organized into three sections. The first section summarizes the current state of knowledge on the experience of disabled people in accessing employment, and the particular role of self-employment. The second has chapters by researchers from different world regions, with examples of the kinds of initiatives discovered. The third analyzes the information that was gathered and concludes the study.
The book is available from : Captus Press Inc., York University
Campus
4700 Keele Street
North York, ON, Canada, M3J 1P3
Phone: (416) 736-5537 Fax: (416) 736-5793
Email: Bob@captus.com Internet: http://www.captus.com
Books and manuals available through TALC
Available (in ENGLISH unless otherwise stated) from:
Teaching-Aids At Low Cost (TALC)
PO Box 49, St Albans, Herts AL1 5TX, UK.
Telephone +44 1727 853869
Fax +44 1727 846852
Women and HIV/AIDS: an international resource book
Covers many issues concerning women, HIV/AIDS, reproductive health
and sexual relationships. Includes resources and contacts.
English: 400 pages, 1993, ISBN 0 04 440876 5
Spanish:400 pages, 1993, ISBN 0 9522417 0 6
How to Make Simple Disability Aids
Shows how to make low-cost aids for people with disabilities from
locally available materials.
76 pages, 1987
Personal Transport for Disabled People
Shows successful designs for local manufacture of wheeled aids,
including wheelchairs, trolleys and tricycles, made up and tested
by disabled people in India, Kenya, Zimbabwe and Malawi.
88 pages, 1984
How to Manage a Health Centre Store
Provides guidelines for running a health centre medical store,
including ordering and storing essential drugs and supplies.
72 pages, 1994 (revised), ISBN 0 907320 25 2
Other assorted CBR books
These books are very hard to find. I ordered the first one, anyone
have the others ?
The Handicapped Community : The Relation Between Primary Health
Care and Community Based Rehabilitation (Primary Health Care Publications,
Vol 7, by Harry Finkenflugel (Editor) Publication date: April
1994
ISBN: 9053832114
Rehabilitation/ Restorative Care in the Community
ISBN 0801624150
Publisher Mosby
Community Rehabilitation Services for People with Disabilities
ISBN 0750695323
Publisher Butterworth-Heinemann, US
Community-based Rehabilitation and the Health Care Referral Services
ISBN 0119515946
Publisher HMSO
Community Based Rehabilitation
ISBN 0702019410
Publisher WB Saunders
Practical Social Research : Project Work in the Community
ISBN 0333606736
Publisher Macmillan P
Across Borders: Women with Disabilities Working Together.
The publisher is Gynergy Books in Canada.
ISBN 0-921881-38-X
Innovations in Developing Countries for People with Disabilities
Brain O'Toole and Roy McConkey (eds). Paul H. Brookes
Publishing, Baltimore. ISBN: 1-870335-18-X
CBR Academic
programs
Not all CBR academic programs follow the WHO model of CBR as defined
by the UN. Wisconsin-Stout, for example, has a huge CBR program
but it doesn't follow the WHO model.
I understand that the City University of Hong Kong, the University of Manchester
in the UK, Queen's University in Kingston, Ontario, Canada, the University of
Sydney in Australia and Auburn University in Alabama all have CBR programs or
courses.
Harry Finkenflugel was kind enough to let us post his PhD thesis on the CBR Resources web page. If you would like a hard copy, please contact Harry directly at finkenflugel@bmg.eur.nl For a digital copy click Thesis
| Erasmus Medisch Centrum Instituut Beleid en Management Gezondheidszorg Postbus 1738 3000 DR Rotterdam tel. 010 408 9701 |
Erasmus Medical Center Institute for Health Care Policy and Management P.O. Box 1738 3000 DR Rotterdam tel ... 31 10 408 9701 |
http://www.erasmusmc.nl
http://www.bmg.eur.nl
http://www.bmg.eur.nl/beno/medewerkers/finkenflugel.html
From the UN
"Community-based rehabilitation (CBR) is a strategy for enhancing
the quality of life of disabled people by improving service delivery,
by providing more equitable opportunities and by promoting and
protecting their human rights. It calls for the full and co-ordinated
involvement of all levels of society: community, intermediate
and national. It seeks the integration of the interventions of
all relevant sectors - educational, health, legislative, social
and vocational - and aims at the full representation and empowerment
of disabled people. It also aims at promoting such interventions
in the general systems of society, as well as adaptations of the
physical and psychological environment that will facilitate the
social integration and the self-actualisation of disabled people.
Its goal is to bring about a change; to develop a system capable
of reaching all disabled people in need and to educate and involve
governments and the public. CBR should be sustained in each country
by using a level of resources that is realistic and maintainable.
At the community level, CBR is seen as a component of an integrated
community development programme. It should be based on decisions
taken by its members. It will rely as much as possible on the
mobilisation of local resources. The family of the disabled person
is the most important resource. Its skills and knowledge should
be promoted by adequate training and supervision, using a technology
closely related to local experience. The community should support
the basic necessities of life and help the families who carry
out rehabilitation at home. It should further open up all local
opportunities for education, functional and vocational training,
jobs, etc. The community needs to protect its disabled members
to ensure that they are not deprived of their human rights. Disabled
community members and their families should be involved in all
discussions and decisions regarding services and opportunities
provided for them. The community will need to select one or more
of its members to undergo training in order to implement the programme.
A community structure (committee) should be set up to provide
the local management.
At the intermediate level, a network of professional support services
should be provided by the government. Its personnel should be
involved in the training and technical supervision of community
personnel, should provide services and managerial support, and
should liaise with referral services.
Referral services are needed to receive those disabled people
who need more specialised interventions than the community can
provide. The CBR system should seek to draw on the resources available
both in the governmental and non-governmental sectors.
At the national level, CBR seeks the involvement of the government
in the leading managerial role. This concerns planning, implementing,
co-ordinating, and evaluating the CBR system. This should be done
in co-operation with the communities, the intermediate level and
the non-governmental sector, including organisations of disabled
people." ("Prejudice and Dignity", E.Helander,
p.8).
Dr Helander now works for the UN Development Programme's Interregional Programme for Disabled People, based in Geneva.
From ICACBR
Community based rehabilitation (CBR) is a response, in both developed
and developing countries, to the need for adequate and appropriate
rehabilitation services, to be available to a greater proportion
of the disabled population. Its aims are to rehabilitate and train
disabled individuals, as well as to find ways to integrate them
into their communities. In CBR, the disabled person, the family,
the community, and health professionals collaborate to provide
needed services in a non-institutional setting, and in an environment
or community where services for disabled persons are seriously
limited or totally absent. Its esssential feature is its focus
on partnership and community participation. Approaches to the
implementation of CBR are many and are determined by a variety
of social and demographic factors. Introducing rehabilitation
services at a local or community level removes many obstacles
to care which are associated with institutions. The difficulty
of travel and its expense are eliminated or reduced to a minimum.
The individual is not isolated from the community; family members
and community volunteers are part of the rehabilitative process.
All participants can see what the disabled person has achieved.
This can help integrate the person into the community, a community
which values the unique contribution which the person is able
to make.
In developed countries, the CBR model responds to the shift away from institutional care to home-based care, and to health-care restructuring in light of reduced funding. In the developing world, CBR provides the focus for training a new corps of health and social personnel. In conflict and post-conflict regions, CBR is being implemented to provide essential rehabilitation services to a population ravaged by war.
Lysack, C, Kaufert, J (1994). Comparing the origins and ideologies
of the independent movement and community based rehabilitation.
International Journal of Rehabilitation Research. v17,
n3, pp 231-240.
Joint position paper by ILO, UNESCO and WHO called Community Based
Rehabilitation, CBR, for and with people with disabilities, issued
in 1994