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The influence of HIV/AIDS on community-based rehabilitation in dar es salaam, Tanzania

BOYCE, William
COTE, Laurence
2009

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Community-Based Rehabilitation (CBR) is the method of choice for delivering services for people living with disabilities in many countries. HIV/AIDS is changing the daily lives of many women by adding to their responsibilities. How realistically can such women participate actively in community development activities like CBR? This paper examines the impact of HIV/AIDS on CBR in Dar es Salaam, Tanzania. Observational sessions and individual interviews were conducted with caregivers of children with disabilities, CBR workers and managers over a three month period. Among the findings was a significant decrease in CBR activities in families affected by HIV/AIDS. This change in family priorities was due to better knowledge of acute diseases and increased stigma of HIV/AIDS in comparison to disability. Older CBR workers were more likely to incorporate elements of HIV/AIDS care with CBR, while younger CBR workers were more likely to avoid HIV/AIDS support. The ability of CBR workers to adapt their working habits to an environment with high HIV/AIDS prevalence is linked to their sense of skill competence and their knowledge/beliefs about risk of infection. Further integration of CBR work with general health development initiatives may improve this situation.

The role and position of disabled people’s organisations in community based rehabilitation : balancing between dividing lines

CORNIEJE, Huib
2009

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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 Organisation and associated organszations behind the new CBR thinking.

This paper deals with the position and role of disabled people themselves in CBR programmes. It critically looks into the role Disabled Peoples’ Organisations in terms of promoting equal access to essential and acceptable quality of rehabilitation programmes for all and especially the poor of this world. It is argued that DPOs should join the ranks of those (professionals) who are committed to ensure that rehabilitation becomes accessible to all. The current global situation of an ever widening gap between the ‘ones who have and those who don’t have’ requires a critical reflection on ones’ own work in CBR and DPO development. We cannot permit ourselves anymore a division among those who are disabled and those who are non-disabled as there are other divides among groups of people that are by far more profound and serious to the majority of disabled people worldwide.

While the urban elite of disabled people who live in a conflict-free, open and democratic society may be well concerned with issues such as accessible tourism, CBR as essential service provision is often unavailable for the poor rural masses and those living under illegal conditions in slums of the cities of Africa, Asia and South America. CBR as philosophy seeks for solidarity with those who live under appalling conditions; threatened by conflict, eviction and hunger. This paper calls for collaboration between DPOs and the CBR movement in order to address diversity and ensure that the implementation of basic human rights are truly addressed.

 

 

Asia Pacific Disability Rehabilitation Journal, Vol 20, No 1

Physical therapy roles in community-based rehabilitation : a case study in rural areas of north eastern Thailand

NUALNETR, Nomjit
2009

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his action research aimed to explore how physical therapists could enhance the quality of life for persons with disabilities via a community-based rehabilitation (CBR) strategy. The study was conducted in two rural sub-districts in northeastern Thailand. In each sub-district, several group meetings were arranged for persons with disabilities and their families, and various community members. Participants were encouraged to discuss their perception of problems of the current rehabilitation services for persons with disabilities. Strategies to manage all problems were collaboratively identified and were implemented in order of priority according to the importance of the problem. The outputs of CBR were evaluated by interviews and observation. The findings revealed that physical therapists had numerous roles in CBR, depending on the community’s circumstances. They need a high degree of flexibility and a wide range of skills to contribute to CBR. The preparation of such physical therapists requires development of a more client-centered community-oriented education programme.

 

 

Asia Pacific Disability Rehabilitation Journal, Vol 20, No 1

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