IT’S time Zambia considered real community-based rehabilitation, but before we talk about this, it’s important to know the aim of community-based rehabilitation.
The aim of community-based rehabilitation is to help people with disabilities, by establishing community-based programmes for social integration, equalisation of opportunities and rehabilitation programmes for the disabled.
Definition of community-based rehabilitation (CBR ), according to three UN systems: ILO, Unesco and the WHO, is a “strategy within community development for the rehabilitation, equalisation of opportunities, and social integration of all persons with disabilities.”
Community-based rehabilitation is implemented through the combined efforts of disabled people themselves, their families and communities and examine appropriate health, education, vocational and social services provided to persons with disabilities through rehabilitation.
It differs from Independent Living of Persons with Disabilities. According to the entire community, this is the target of CBR programmes; the CBR model is one of community developments or partnerships that place control squarely with disabled consumers.
The United States builds the best rehabilitation institutions in the world but persons with disabilities 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.
Community-based  rehabilitation is a strategy for enhancing the quality of life of disabled people by improving service delivery, providing more equitable opportunities and promoting and protecting their human rights.
It calls for the full and coordinated 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.
It’s 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 and depends on decisions taken by its members. Community-based rehabilitation mostly relies as much as possible on the mobilisation of local resources and ensures community participation.
The families of the disabled persons are the most important resource for any successful community-based rehabilitation.
Through community-based rehabilitation skills and knowledge are promoted by adequate training and supervision, using a technology closely related to local experience.
The communities support the basic necessities of life and help the families who carry out rehabilitation at home.
Community-based rehabilitation further opens up all local opportunities for education, functional and vocational training, and jobs within community centres. Under community-based rehabilitation it’s a duty of the community 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.
At the intermediate level, a network of professional support services should be provided by the Government and not cooperatives.
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.
Community-based rehabilitation (CBR) is a response, in both developed and developing countries, to address 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 find ways to integrate them into their communities.
In CBR, the disabled person, family, 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 essential 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.
Vocational rehabilitation services are services implemented with a view to qualifying the disabled for the appropriate line of work, employment, keeping of an employment, promotion or change of a professional career.
Vocational rehabilitation constitutes rights of the disabled persons to individual services, such as counseling, encouraging and motivating the disabled for active participation, the drawing-up of an opinion on the level of working capacity, skills, working habits and occupational interests, provision of assistance in the area of acceptance of invalidity and acquaintance with the possibilities for the integration in training and work, provision of assistance in the area of selection of appropriate occupational objectives, development of social skills and provision of assistance in the area of finding appropriate work and employment, respectively.
Community-based rehabilitation is a method by which people with disabilities are rehabilitated within their locality, so if we are to address challenges of persons with disabilities in Zambia and other
African countries, community-based rehabilitation is the best approach.
(For your letters please send to us on P.O Box 34490, Lusaka, Zambia or use our South African address. The author is regional disability policy analyst for SADC and inclusive development advisor for Centre for Disability Development Research, Law and Policy, Johannesburg. Project office, P.O Box 1981, New Castle, 2940 South Africa.
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