(Poverty and disability, The World Bank)….
No rehabilitation services are available to people with disabilities in 62 countries.” (Global survey on government action on the implementation of the standard rules on the equalization of opportunities for persons with disabilities, UN).
In September 2000, UN Member States adopted eight Millennium Development Goals (MDGs) which range from eradicating extreme poverty and hunger to providing universal primary education, all by the target date of 2015. These internationally agreed development goals represent the benchmarks set for development at the start of the new century… Therefore in November 2009, the sixty-fourth UN General Assembly adopted a resolution on realizing the millennium development goals for persons with disabilities.
In November 2004, ILO, UNESCO and WHO invited 65 disability, development and Community Based Rehabilitation (CBR) experts to initiate development of WHO CBR programme guidelines….
This group included CBR pioneers and practitioners, individuals with personal experiences of disability and representatives from UN organisations, Member states, leading international nongovernmental organisations, disabled peoples’ organisations, professional organisations and others. The meeting resulted in the drafting of the CBR matrix which provided the scope and structure for their guidelines.
The WHO CBR programme is excellent and extensive. It provides rehab in areas complementing Developing Physio (eg. ante and post natal, midwifery, cancer care, OT, Speech Therapy, Learning difficulties, congenital disabilities, drug and addiction therapy and epilepsy). However they only have a very basic level of physical rehab, usually all carried out by the same person doing the midwifery, etc.
Developing Physio runs parallel with the WHO CBR programmes without overlap. We aim to eventually contribute to their programmes by providing our specialised easy to follow community based rehab modules in physiotherapy skills.
The convention on the rights of persons with disabilities describes people with disabilities as “those who have long-term physical, mental, intellectual or sensory impairment”. Developing Physio concentrates on the physical rehabilitation
For example in Malawi and the Republic of Tanzania, the probability of children never having attended school is doubled if they have disabilities….
People with disabilities tend to experience higher unemployment and have lower earnings than people without disabilities.”
(Facts on disability in the world of work, Geneva, International Labour Organisation).
In 2006 the UN General Assembly adopted the Convention on the Rights of Persons with Disabilities. Built upon the UN standard rules, on the equalization of opportunities for persons with disabilities, the World Programme of Action Concerning Disabled Persons and complements existing human rights frameworks. The Convention was developed by a committee with representatives from governments, national human rights institutes, nongovernmental organisations and disabled people’s organisations. Its purpose is “to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, to promote respect for their inherent dignity.”
(World Health Organisation, Geneva)….
“People with disabilities constitute the world’s largest minority…
An estimated 80% of people with disabilities live in developing countries.”
(Convention on the rights of persons with Disabilities, UN).
“No rehabilitation services are available to people with disabilities in 62 countries.” (Global survey on government action on the implementation of the standard rules on the equalization of opportunities for persons with disabilities, UN).
In September 2000, UN Member States adopted eight Millennium Development Goals (MDGs) which range from eradicating extreme poverty and hunger to providing universal primary education, all by the target date of 2015. These internationally agreed development goals represent the benchmarks set for development at the start of the new century… Therefore in November 2009, the sixty-fourth UN General Assembly adopted a resolution on realizing the millennium development goals for persons with disabilities.
(Assistive devices/technologies:What WHO is doing, Geneva)…..
Unless disabled people are brought into the development mainstream, it will be impossible to cut poverty in half by 2015 or to give every girl and boy the chance to avchieve a primary education by the same date (which is among) the goals agreed to by more than 180 world leaders at the UN Millennium Summit in September 2000“.
(James Wolfensohn, former President of the World Bank, Washington Post, December 2 2002).
(WHO)…..
The World Bank and the World Health Organisation claim that “Development initiatives have often been top-down, initiated by policy makers at locations far removed from community level and designed without involvement of the community. It is now recognized that one of the essential elements of development is involvement of the community as individuals, groups or organisations, or by representation, in all stages of the development process including planning, implementation and monitoring. (Handicap International, Sweden). A community-based approach helps to ensure that development reaches the poor and marginalized, and facilitates more inclusive realistic and sustainable initiatives. Many agencies and organisations promote community approaches to development, this is exactly what Developing Physio aims to do.
(Kofi Annan, former UN secretary-General)…..
“CBR research relating to low-income countries has increased drastically in recent years, both in quality and quantity.”
(The Evidence base for community-based rehabilitation: a literature review. International journal of rehabilitation research 2005.)
Based on published reviews of CBR research and other literature, rather than individual studies, the following facts can be noted:
“CBR-type programmes have been identified as effective.” R Mitchell, The research base of community based rehabilitation. Disability and rehabilitation, 1999, 21) “and even highly effective”
Mannan H, Thurnbull, Asia Pacific Disability Rehabilitation Journal, 2007, 18.
CBR outcomes include increased independence, enhanced mobility, and greater communication skills of people with disabilities.
(Evidence for the effectiveness of rehabilitation-in-the-community programmes).
In educational settings, CBR has been found to assist in the adjustment and integration of children and adults with disabilities… The CBR approach has been found to constructively facilitate the training of community workers in the delivery of services.
(A review of community based rehabilitation evaluationa: Quality of life as an outcome measure for future evaluations. Asia Pacific Disability Rehabilitation Journal, 2007)
The government of the Islamic Republic of Iran piloted a community-based rehab programme in two regions in 1992…..
The programme was successful and was scaled up in 1994 to cover a further six regions. By 2006 national converage was achieved across all 30 provinces. The social Welfare Organization, under the ministry of Social Welfare, is responsible for management of the CBR programme across the country and over 6000 personnel including community workers, middle level CBR staff, physicians, CBR experts and CBR managers are involved in implementing CBR activities. More than 229,000 people with disabilities have been supported by the national CBR programme since 1992. World Health Organisation.
Funding
It is important that all CBR programmes develop stable funding sources. A range of different funding options may be available, including government funding (eg direct financing or grans) donor funding (eg submitting project proposals to national or international donors for funding, in-kind donations or sponsorship), and self-generated income (eg. Selling products, fees and charges for services or microfinance). It is therefore essential for us to seek financial resources for the development of new programmes or to enable existing programmes to continue their work:
Sustainability
While good intentions help to start CBR programmes, they are never enough to run and sustain them. Overall, experience shows that government-led programmes or government-supported programmes provide more resources and have a larger reach and better sustainability, compared with civil society programmes. However, programmes led by civil society usually make CBR more appropriate, make it work in difficult situations, and ensure better community participation and sense of ownership. CBR has been the most successful where there is government support and where it is sensitive to local factors, such as culture, finances, human resources and support from stakeholders including local authorities and disabled people’s organisations. (WHO).
If you agree that these facts demonstrate the absolute need for rehabilitation in developing countries and you want to get involved, please contact us.