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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

Best practices in the socio-economic rehabilitation of persons affected by leprosy and other marginalised people in their communities: findings from nine evaluations in Bangladesh, India and Africa

VELEEMA, Johan P
2008

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This paper presents an overview of findings from the formal evaluation of 9 socio-economic rehabilitation programmes (SER), in 4 countries in Africa, in Bangladesh and in India from 2002-2005. Bringing together the recommendations resulted in a description of best practices in the implementation of socio-economic rehabilitation programmes, derived from actual experiences in different contexts.

All the 9 programmes focused on supporting individual leprosy-affected beneficiaries or their families. Four projects also supported other marginalised clients. The usual interventions were micro-credit, housing and sponsoring of education for the children.

The recommendations touched upon each of the five steps in individual rehabilitation: Selection of clients, needs assessment, choosing an intervention, monitoring / follow--up of clients during rehabilitation, and separation at the end of the rehabilitation process. The evaluators also suggested ways in which participation of the client in their own rehabilitation might be boosted, made recommendations for the organisational structure of programmes, on maximising community involvement and emphasised the importance of information systems and of investing in the programme staff. A number of recommendations were specific to the types of interventions implemented i.e, housing, education or micro-credit.

Evidence of the impact of SER on the quality of life of clients is limited, but suggests increased self-esteem and increased respect/status in the family and community.

 

Asia Pacific Disability Rehabilitation Journal, vol.19, no.1, 2008

Exclusion of disabled people from microcredit in Africa and Asia : a literature study

CRAMM, J M FINKENFLUGEL, H
2008

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People with disabilities are barred from microcredit schemes. A literature search on the participation of people with disabilities in microcredit schemes resulted in 16 documents. The statements, recommendations and generalisations in these documents are not supported with strong evidence and are 'expert opinions' at best. Inclusion of people with disabilities within institutional schemes and self-helping schemes is recommended throughout the world. However, these seem most affected by excluding mechanisms and inclusion numbers lag behind. The absence of people with disabilities from these two schemes makes them a less attractive option. To fulfil the current needs of people with disabilities; ad-hoc schemes should continue and even expand their work. The pragmatic solution is to work with the available resources in order to change the situation of people with disabilities.

Factors shaping attitudes towards physical disability and availability of rehabilitative support systems for disabled people in rural Kenya

MONK, Julie
WEE, Joy
2008

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This study examines the range of attitudes towards persons with physical disability in a rural community in western Kenya. It also evaluates the availability of services for persons with disabilities in the community. Qualitative data analysis of interview material led to the generation of a model describing the attitudes towards people with disabilities. Availability of services was explored through interview questions and document collection. Perceived cause of disability, perceived characteristics and activities of people with disabilities by the community and perceived role of society, appear to shape the attitudes towards people with disabilities in the community studied. The opinions within these categories contribute to enabling and disabling features of the environment in which people with disabilities live. It appears that services available are underused by disabled members of the community due to poor accessibility and financial barriers. The results yielded relatively enabling attitudes towards PWD. The responses suggest that this community may be ready to support increased participation by its members, possibly through a community based rehabilitation programme.

 

Asia Pacific Disability Rehabilitation Journal, Vol 19, No 1

Reflections on poverty and disability : a review of literature

KAMPEN, Marlies V
ZIJVERDEN, Ingrid M
EMMETT, Tony
2008

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This study carried out a review of literature describing the relationship between poverty and disability, in order to establish the evidence base for this relationship. Several authors seem to accept the existence of this link, even without a sound research basis. Articles and books were scrutinized to find out what sources were used in these publications to conclude that there was evidence for a strong relationship between disability and poverty. Peer-reviewed articles were used as much as possible.

It was found that cultural determinants play the greatest role in the process of disability leading to poverty. Monetary factors are also essential determinants when it comes to poverty as a result of disability. The relationship between disability and poverty seems to be a vicious circle. Most of the literature concerning poverty and disability is based on non- rigorous (literature) studies.

Relating disability to poverty and vice versa is a complex matter that needs to consider several interdependent factors that influence this process.

 

 

Asia Pacific Disability Rehabilitation Journal, Vol 19, No 1

Practice and preferences of sign languages in the instructions of deaf students: some reflections on the mainstream secondary school of Botswana

LEKOKO, Rebecca N
MUKHOPADHYAY, S
2008

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The use of language for every day communication has been and continues to be an essential element of any teaching and learning environment. In this paper, the focus is on the teaching -learning communication in the education of the learners with deafness. While experiences indicate that some people in Botswana are showing more and more interest in Sign Language as a mode of instruction in the classroom, it is also true that many are far from understanding the "Deaf Culture" and to use sign language in the teaching and learning of deaf students. To a great extent, deaf people in Botswana are still disadvantaged and discriminated against, by their condition. A survey carried out in 2004 (1) revealed that some current practices in the mainstream secondary school of Botswana make it difficult for deaf students to progress. While, for example, participants preferred Total Communication; in practise, Signed English is used. Thus, this paper takes a stance that if practices conflict with preference, low performance should be expected. This is currently the situation at the mainstream secondary schools in Botswana, deaf students' inability to hear has become their inability to learn and progress in education. This could be avoided. In this 21st century, being unable to hear is not a barrier to learning, as we are aware that Sign Languages are there as full languages, for the education of deaf.

 

Asia Pacific Disability Rehabilitation Journal, Vol 19, No 1

Disability and development: is the rights model of disability valid in the Arab region? An evidence-based field survey in Lebanon and Jordan

NAGATA, Kozue Kay
2008

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This paper reviews the process and outcome of constructing a "rights model of disability" which is culturally specific to Jordan and Lebanon. The objective of the empirical part was, to survey the current level of attitudes of non-disabled people towards their disabled fellows in Jordan, and to compare the attitudes of Lebanon's university students towards five different categories of disabled people (mentally disabled people, psycho-socially disabled people, physically disabled people, hearing impaired people and visually impaired people) to highlight the variations and diversity among them. It also examined the relationship between the attitudes and various demographic and social characteristics of the respondents. The set of findings was further tested and triangulated through meta-analysis of individual views expressed in the qualitative studies.

In Jordan, the attitude of 191 randomly selected non-disabled people was studied, using a Scale of Attitudes towards Disabled Persons (SADP). The participants from 4 communities of Jordan, exhibited overall negative attitudes towards disabled people. Socio-economic-demographic characteristics showed almost no difference regarding their attitudes towards disabled people.

In Lebanon, a more complex scale, composed of four sub-scales, namely a, "Baseline Survey of Student Attitudes towards People with a Disability" was used, to survey 94 university students' attitudes towards five different categories of disabled people, and a set of indices for future comparison was constructed. The results indicated the same pattern of gradations of attitude differences (found in other countries) towards persons with physical or sensory impairments (better), intellectual impairment (middle) and mental illness (worse). The main findings of this empirical field research showed particularly negative public attitudes towards people with intellectual impairment and mental illness in Lebanon.

Finally, the validity of the proposed rights model of disability and the empirical findings of this study, were further examined and co-validated through analysis of the collective views of those who took part in the questionnaire surveys and the participatory focus group discussions, which took place in Lebanon in 2005 and 2007, and in Jordan in 2005, as well as a series of intensive on-line and/or telephone interviews of a few informants comprising of disabled persons and experts. The policy implications of the findings are discussed.

 

Asia Pacific Disability Rehabilitation Journal, Vol 19, No 1

Beyond community based rehabilitation: consciousness and meaning

CHEAUSUWANTAVEE, Tavee
2007

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This article seeks to explore CBR through different perspectives. Based on existing literature and research on CBR, the paradoxes between CBR as ideal and CBR in usual practice, are identified. The dual meaning of 'disability' through 'stigma' and 'empowerment' perspectives is explored, along with the dual understanding of 'community consciousness' as 'individualism' and 'collectivism'. The two dimensions of 'disability' and 'consciousness' together are characterised into four distinct paradigms. Most past rehabilitation services are placed in a stigma-collective paradigm. It implies that philanthropy, inter-subjective value, morality and public awareness of society have usually constructed and supported any help and services for people with disabilities, including CBR. This paper looks at limitations of the past perspectives on CBR, and also points out the need for 'consciousness' studies on CBR. To understand the discrepancies of CBR, people need to look "beyond" CBR as it is commonly understood.

 

Asia Pacific Disability Rehabilitation Journal, Vol 18, No 1

Gendered experiences : marriage and the stigma of leprosy

TRY, Leonie
2006

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Stigma is rife in many areas of health and healthcare and it has implicit impacts that are often overlooked. Due to the continued social construction of the stigma of leprosy, it is clear that a greater understanding is needed of how stigma is experienced. This study considers the experiences of marriage of those vulnerable to stigmatisation due to leprosy and more specifically identifies different experiences of leprosy-affected women and men and the possible implications.

Challenges in leprosy rehabilitation

THOMAS, Maya
THOMAS, MJ
2004

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‘Multiple drug Therapy’ (MDT) has transformed the outcome of leprosy in people affected by it. Leprosy affected persons develop much less disfiguring disabilities after use of MDT. As a result leprosy services are now becoming integrated into general health services. When this integration becomes stronger, leprosy rehabilitation is also likely to adopt methods followed by general health services. Vertical, stand-alone services, based on single aetiology like leprosy, will require some adaptation to fit in with the environment of general health services. The authors speculate that changes in leprosy rehabilitation could make ‘community based rehabilitation’ (CBR) an important method for the vast majority of leprosy patients who need rehabilitation. This paper discusses some of the concerns regarding the suitability of CBR for leprosy rehabilitation.

 

Asia Pacific Disability Rehabilitation Journal, Vol 15, No 1

Training of CBR personnel : current issues future trends

THORBURN, M J
2000

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This paper reviews the main trends that have taken place in training persons for CBR work in the last twenty years. It stresses the relevance of the Canadian manpower model to CBR and the logical approach to training generated. New trends for the near future are outlined and a need for more research is seen as crucial to future developments

Influence of cultural factors on disability and rehabilitation in developing countries [Editorial]

ASIA PACIFIC DISABILITY REHABILITATION JOURNAL
1999

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Western stereotypes of 'community' are used in the planning of many CBR programmes in developing countries. These programmes expose themselves to a higher risk of failure because they tend to conflict with the cultural factors of the host country. This editorial illustrates the significance of cultural influences on disability and rehabilitation in the context of CBR

Framing disability issues in local concepts and beliefs

GROCE, Nora Ellen
1999

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This paper discusses three issues...[for] consideration as part of the evolving discussion of disability in a cross-cultural context. The first concerns seeing socially constructed concepts and beliefs about disability as ideas and attitudes that are often, and increasingly, in transition and not as static conceptual frameworks. The second issue deals with determining the best methodology to understand disability in the individual, family, community and societal setting out of the many methodologies that can be employed in these situations...The third issue is about ensuring that the information gathered is disseminated broadly, which means sharing the information generated not only with those interested in disability issues, but also with those working on issues such as development policy, social change and justice, who know little about disability

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