Community Base Rehabilitation Strategy and Independent Living Approach

CBR NATIONAL SEMINARCBR NATIONAL SEMINAR

1616thth and 17 and 17thth 2012 2012

BhaktapurBhaktapurPresented By:-Presented By:-

Krishna GautamKrishna Gautam

access the benefits of the health, education, livelihood and social sectors

empowerment through facilitation of the inclusion and participation and communities in all development and decision-making processes.

influenced by the Convention on the Rights of Persons with Disabilities (CRPD)

training family and community members on disability and CBR using the WHO CBR training manual as a guide;

providing educational assistance and facilitating inclusive education through capacity building with teaching staff and students, and improving physical access;

referring people with disabilities to specialist services, e.g. surgical and rehabilitation services, where physiotherapists, speech therapists and occupational therapists are available;

providing assistive devices, e.g. walking sticks, crutches, wheelchairs, hearing aids, glasses;

creating employment opportunities by providing access to training, job coaching and financial support for income-generation activities;

providing support for social activities including for sports and recreation;

providing financial assistance for living, education and home modifications.

Poverty has many aspects: it is more than just the lack of money or income. “Poverty erodes or nullifies economic and social rights such as the right to health, adequate housing, food and safe water, and the right to education. The same is true of civil and political rights, such as the right to a fair trial, political participation and security of the person...”

Inclusive development is that which includes and involves everyone, especially those who are marginalized and often discriminated against. People with disabilities and their family members, particularly those living in rural or remote communities or urban slums, often do not benefit from development initiatives and therefore disability inclusive development is essential to ensure that they can participate meaningfully in development processes and policies.

Human rights are internationally agreed standards which apply to all human beings as everybody is equally entitled to their human rights – e.g. the right to education and the right to adequate food, housing and social security – regardless of nationality, place of residence, sex, national or ethnic origin, colour, religion, or other status. These rights are affirmed in the UDHR as well as in other international human rights treaties which focus on particular groups and categories of populations, such as persons with disabilities.

The early years The declaration of Alma-Ata in 1978 was the first

international declaration advocating primary health care as the main strategy for achieving the World Health Organization’s (WHO) goal of “health for all”.

Early programmes were mainly focused on physiotherapy, assistive devices, and medical or surgical interventions. Some also introduced education activities and livelihood opportunities through skills-training or income-generating programmes.

In May 2003, WHO in partnership with other UN organizations, governments and international nongovernmental organizations including professional organizations and disabled people’s organizations, held an international consultation in Helsinki, Finland, to review CBR. The report that followed highlighted the need for CBR programmes to focus on:

reducing poverty, given that poverty is a key determinant and outcome of disability;

promoting community involvement and ownership; developing and strengthening of multispectral

collaboration; involving disabled people’s organizations in their

programmes; scaling up their programmes; promoting evidenced-based practice.

In light of the evolution of CBR into a broader multisectoral development strategy, a matrix was developed in 2004 to provide a common framework for CBR programmes. The matrix consists of five key components – the health, education, livelihood, social and empowerment components. Within each component there are five elements. The first four components relate to key development sectors, reflecting the multisectoral focus of CBR. The final component relates to the empowerment of people with disabilities, their families and communities, which is fundamental for ensuring access to each development sector and improving the quality of life and enjoyment of human rights for people with disabilities.

A new movement…

1970's decade PWDs America denied IBL

1972, Ed Roberts founded the Barkley IL Center 1978, amendment of Rehabilitation Law

An academic paper by Gerben Dejong drastically changed the way of thinking toward disabilities, from rehabilitation to Independent Living

From 1968 to 1992, a number of laws were created that established certain civil rights for persons with disabilities.

These laws addressed architectural barriers, discrimination against persons with disabilities in federally funded programs, education rights for children with disabilities, "Bill of Rights" for persons with developmental disabilities and mental illness, discrimination in housing, consumer control over their own vocational rehabilitation plans, and creation of Centers for Independent Living.

In the 1950s, blacks protested because they had to sit in the back of the bus; in the 1970s, people with disabilities protested because they couldn't get on the bus! We, too, are fighting blatant and subtle prejudice, building pride in who we are, and protesting discrimination in non-violent ways.

(10 points IL Kathmandu Declaration)

Rally on the occasion of Training/Seminar

Training/Seminar at Hotel Radisson

Different Activities based on

Movement

Live with Dignity in chosen community The right to choose how you live, with whom you live, what degree you wish to interact with your community.

Participate in every aspect of life Having Access to any support you might need to

realize those choices and to achieve an adequate standard of living.

Control and make Decision about own livesHaving the right to examine options, make choices, take risks, and even to make mistakes in the learning process.

Human Rights: equal rights & opportunities for all; no segregation by disability type or sterotype.

Consumerism: a person who us using or buying a service or product decides what is best for him or herself.

De-institutionalization: no person should be instutionalized.

De-medicalization: PWDs are not sick

Self-help: Professional are not the source of the help provide

Contd....

Advocacy: protect human rights, ensure PWDs rights from all stakeholders.

Barrier Removal: architectural, communication and altitudinal barriers must be remove.

Consumer Control: PWDs are governed, managed, staffed and operated by PWDs

Peer role Models: leadership for living independently and disability rights is vested in PWDs.

Cross–Disability: work done by different types of disability

ALL PERSONS WITH DISABILITIES HAVE THE SAME RIGHT AS ANYONE ELSE TO LIVE IN THE COMMUNITY, TO BE FULLY INCLUDED AND TO PARTICIPATE IN THE COMMUNITY

a)Persons with disabilities have the opportunity to choose their place of residence and where and with whom they live on an equal basis with others and are not obliged to live in a particular living arrangement;

b)Persons with disabilities have access to a range of in-home, residential and other community support services, including personal assistance necessary to support living and inclusion in the community, and to prevent isolation or segregation from the community;

c) Community services and facilities for the general population are available on an equal basis to persons with disabilities and are responsive to their needs.

Living independently and being included in the community:Living independently and being included in the community:

Physical barriers to places of work, shops, education, health facilities, public buildings and public constructions.

Lack of accessible transportation, technologies, communication

Legislation, regulations, policies or practice that forces PWDs to live segregated and institutional or forced to live in home or community setting against their will.

Lack of accessible information about services, rights and responsibilities to support living independently.

Lack of Resources allocation, investment, need base activities

Attitudes people with disabilities to live where and with whom they choose and to make decisions for themselves.

Issues CBR IL

Builds on Inter -dependence Independence

Services for Children

Yes 50-50

Primary Ages Services

All ages Over 16 Years

Consumer Controlled

Not necessarily Yes

Strength Research those in greatest need

PWDs define needs/demand rights

Weakness Organized for, not by PWDs

Middle class oriented, poor are left out

Primary Intervention

Yes NO

Secondary Intervention

Yes NO

Tertiary Intervention

Yes Yes

Benefited Normal rather than SPWDs

Conflict and post conflict situations are little considered as priority concerns for development agenda. Education system for CwDs has always remained a challenge Inclusion is much talked, little practiced indicate a wide gap No specific and adequate policy and programs or mechanism to support CBR or IL activities. Existing laws, by laws are non obligatory and Charity oriented rather than based on rights Geographical difficulties Allocation of the budget i.e. empowerment, assistive devices, PAS, accessibility, housing, transportation, technologies, employment or allowances. Nation doesn’t accept disability as its prioritized area to promote the rights of the PWDs. • Political instability

DPOs strongly advocating, lobbying and enforcing the government to implement UN CRPD and nationalize the laws, by laws and policies with the collaboration of DPOs nationwide

It is one of the most significant and positive signals to accept disability and IL activity as its priority concerns to impart services to PWDs by Nepal Government.

The major political are recognizing PWDs and their DPOs as their valued stakeholders and sister organizations to perceive political rights

Efforts have been made to mention disability rights as the Special Rights of the PWDs on newly made constitutional draft to make it disabled friendly.

The allocation of budget at local government bodies for the development and empowerment of PWDs through SHOs under Ministry of Local Development

Government

PWDs Centers

We're here, we're united, and we're not going away!

Thank you very much for listening me.

Lets Change the Society Working Together!