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Life Situations of persons with disabilities
in
Developing Countries
Community Based Rehabilitation:
Involving the Family
By:
Hissa Al-Thani
Special Rapporteur on Disability
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Presentation Content:
- The last three decades witnessed important
achievements for persons with disabilities.
Building on the Universal Declaration of
Human Rights and other Covenants and
Conventions.
- The Disability movement left its mark on the wall of history:
-
The UN Decade of Disabled Persons (1983 – 1992 )
- The universal adoption of the Standard Rules on the Equalization
of Opportunities for Persons with Disabilities in 1993
The Growth of number and membership of the Organizations of
Persons with Disabilities worldwide.
- Despite all these achievements the
situation of persons with disabilities is
far from reaching its goals and has a
long way to go.
- Facts:
-
Persons with disabilities,
particularly in the
developing world, are
trapped in a cycle of
poverty and exclusion
- Girls with disabilities in
developing countries as
twice as likely to suffer
neglect than boys.
- An estimated 170 million
children are malnourished.
1 in 10 children has a
developmental disability.
- More than 80% of people
with disabilities and their
families live in the
developing world
(500 MILLOIN)
- In the recent World Bank meeting that I attended
in Washington to discuss the Global Partnership
for Development, Mr. James Wolfensen, World
Bank President stressed that :
unless the issues of people with disabilities are
brought into the development agenda, it will not
be possible to meet the Millennium Development
Goal on poverty reduction by the year 2015.
- Defining Rehabilitation
According to paragraph 25 of the Introduction to the
Standard Rules, the term "rehabilitation" refers to
"a process aimed at enabling persons with disabilities to reach
and maintain their optimal physical, sensory, intellectual,
psychiatric and/or social functional levels, thus providing them
with the tools to change their lives
towards a higher level of independence."
- In the early 1980 the United Nations World
Programme of Action Concerning Disabled
Persons along with the WHO through their
programme of Disability Prevention and
Rehabilitation, initiated the concept of
Community Based Rehabilitation (CBR).
- During the past 15 or so years there has been a substantive and
substantial growth in the number of CBR programmes in
many developing countries.
With this grew the understanding that CBR needed to deal with
issues related to the lives of Persons with Disabilities and
taking into consideration the context in which people with
disabilities live.
- Why CBR in Developing Countries??
- Rehabilitation Issues and Observations in
Developing Countries
-
Most rehabilitation services are found only in urban centers, and
are available only to those families that can afford them
- Most of these facilities use methodologies imported from countries
of the North without being adapted to the needs of children with
disabilities in their environment.
- Parents, particularly less educated, working class or poor parents,
are often alienated from their child's rehabilitation process by
cultural and social traditions.
- In the Arab world, for example, parents have been indoctrinated in
the "doctor knows best" philosophy and are often intimidated
by professionals.
- Children with Disabilities are always at risk of
discrimination and neglect and are particularly
vulnerable when there is a shortage of resources.
- An estimated 97% of disabled children in developing
countries are denied even the most basic
rehabilitation even in the wealthy developed
countries, the birth of a disabled child is almost
invariably viewed as a tragedy.
- In many developing countries - specifically in
poor rural communities - the involvement of
medical and rehabilitation professionals,
where and when it is available, is only at the
initial stages, and in the long run a family is
left alone to cope with the needs of that child.
- Where rehabilitation services are available and
accessible to the family, they usually follow the topdown
model, in which rehabilitation and medical
professional "prescribe to and provide for" the child
without consulting, involving, informing or educating
the family.
- The late Mudhukar Suryavinshi of the International
Council for the Education of People with Visual
Impairments, describes a state of "limbo" in which
the child finds herself after her rehabilitation is "completed" where the family is unable to adjust or
understand the needs of the child.
- CBR: Building Bridges to the Family
-
Rehabilitation services need to always consider that
the family is the first and most important social unit for
the child.
- Not only the family is the child's primary care giver, but it
can also be tapped as a rich and vast resource in the
Rehabilitation process of a child with disability.
-
The first step to involving the family is to show
understanding of the feelings its members are
experiencing through a holistic approach to
the wider family circle.
- Community Based Rehabilitation
-
T The term CBR covers a wide range of initiatives:
- At one end of the spectrum are large CBR programs
launched by government.
- At the opposite end of the spectrum are the small community
programs run by the persons with disabilities, or by families of
children with disabilities
- CBR programs in developing countries are popular
and successful not only in rural and remote areas where
services are hard to come by, but in urban centers as well .
- Is it possible to have CBR programmes, initiated, led and
managed by people with disabilities and their families in
every community and which would fulfill the needs of all
adults and children with disabilities?
- According to a WHO estimate, the needs of 70% of people
with disabilities in developing countries could be met at the
community level, while 30% who have severe or multiple
disabilities would need special interventions from time to
time of the kind that is not available in the local community.
- With the provision of the necessary resources, human,
financial and educational, CBR programs can be
made to meet the needs of most children and
people with disabilities within their communities
- These competing needs and priorities often create
friction and contradiction in the delivery of
services and in the levels of commitment to the
rehabilitation process.
One of those competing interests especially in
developing countries, are the needs of girls and
women with disabilities
- Can CBR programs help change social attitudes
towards people with disabilities, and women
with disabilities in particular?
- CBR programs will need to develop appropriate
Strategies to address issues related to traditional, social
and cultural Perceptions through awareness raising .
- Women's organizations in developing countries need
to be educated to include the rights disabled women
- Policy Recommendations for Effective CBR
in Developing Countries
-
Establishing community based rehabilitation
programs that are inclusive sensitive, and
democratic in their approach
- Initiating CBR Programs in rural, tribal, remote
communities in developing countries with the help
of professionals and experts whose aim is to empower
people with disabilities and their families
- Encouraging NGOs to work with the medical community
and to sensitize it to the practical ,emotional and
psychological needs of families of children with disabilities
- Soliciting the support of international DPOs in
establishing, launching, and training small communities
in the South to take the lead in CBR initiatives
- Raising community and social awareness,
through targeted CBR services, to the needs of
girls and women with disabilities
- Encouraging children with disabilities to become
role models for other children
- Encouraging adults with disabilities to take leadership
roles in CBR programs targeted to children with
disabilities and their families
- Allowing children with disabilities to exercise their right
in voicing their needs and their aspirations
- Providing education and employment opportunities for
children and adults with disabilities and enabling
them to become full participating members of society
- Promoting collaboration between NGOs, DPOs and
agencies as UNICEF, UNESCO to ensure that the needs
of girls with disabilities are included in programs
targeted at girls in developing countries
- THNAK YOU
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