CBR as it developed in the late seventies and early eighties was largely a response to the physical rehabilitation needs of many disabled people who by that time were not reached through so-called institution-based rehabilitation. CBR became an approach to make rehabilitation accessible to disabled people at the community level. CBR in those days developed from within a medical model perspective, implemented in the context of the health sector, and was concerned with coverage.
The role of disabled people in CBR is increasingly being seen as of vital importance for the success of CBR. In actual fact, participation of disabled people and self advocacy have become two of the principles of CBR as seen by the World Health Organization and associated organizations behind the new CBR thinking.
During this session, the participants discussed the following points:
• CBR resources available in the various countries to share with each other, in terms of information, training and material resources
• The role that APCD can play as a facilitating and coordinating agency for the collection and dissemination of these resources.
CBR is considered as the most significant innovation over the last quarter century for people with disabilities, especially for those in rural areas in developing countries. The positive benefits of CBR are documented in evaluation studies from different countries. The term “CBR” is now a strong brand in itself, recognised all over the world. It is arguably the only “brand” that has survived for such a long time in the development sector.
The key questions for discussion on this theme were:
• Why are partnerships needed between DPOs and CBR?
• What are the barriers to such partnerships?
• What strategies are needed to build more effective partnerships between DPOs and CBR?
The WHO CBR Matrix is a framework for inclusive development and all the six components (health, education, livelihood, social, empowerment and environment) are crucial in ensuring full participation and equality of persons with disabilities in a community where they reside. In the past, CBR tended to be limited in focus, with mainly individual focused “interventions”, such as medical, educational or vocational aspects.
APCD identified four barriers of a societal environment: firstly, the built environment such as buildings and transportation; secondly, an information communication barrier such as sign language, Braille and ICT accessibility; thirdly, regulations and laws excluding persons with disabilities from the community, organizations and government such as becoming a medical doctor, a professional, and sometimes getting a driver’s license; fourthly, people’s attitude such as attitudinal discrimination, which is the biggest barrier.
APCD has been promoting the “Environmental Model” which promotes an inclusive, barrier-free and rights-based society. However, some traditional rehabilitation has encouraged persons with disabilities to become like persons without disabilities in order to integrate into the community. So, rehabilitation workers might view persons with disabilities as the problem. On the other hand, the environmental model identifies the exclusive community system as the problem.
CBR identifies resources within its community for sustainability. Therefore, the core stakeholders of CBR implementation are basically community members with professional CBR workers who could be from outside the community. CBR workers and persons with disabilities from outside the community should not control the project but rather play supportive roles. Community people, particularly persons with disabilities, ought to have ownership of the CBR program since it is persons with disabilities who know the real needs in their communities.