Of Community Based Rehabilitation

The National Policy on Equalisation of Opportunities for Persons with Disabilities adopts the Community-Based Rehabilitation (CBR) as a national strategy in view of its proven potential to contribute to the empowerment of persons with disabilities in selected districts in Malawi. For someone new to the disability rights advocacy, the term CBR may seem puzzling at the first sight. In this case, we will endeavour not only to define the term but also provide more practical elucidation and historical insights.

There is a wide diversity of meanings currently attached to the term “CBR”. The reason is that CBR is not just a concept or a working definition, but also an ideology, assuming that community members are willing and able to mobilise local resources and to provide appropriate services to their persons with disabilities. The debate is very much about how far local people can do this by themselves. We therefore have to first agree on a ‘working definition” of CBR for this article. Most users of the term “CBR” might agree with Dr. Geert Vanneste’s definition, a medical doctor at CCBRT Hospital in Dar Es Salaam, Tanzania:

“CBR programmes improve, facilitate, stimulate and/or provide services to people with disabilities and their families and caretakers; within the locations of their families and communities; through local, full time or part time, paid or volunteer, community rehabilitation workers; who are being trained, followed up and managed within a certain organisational set-up”.

If you critically examine Vanneste’s definition, you will clearly see that CBR focuses on enhancing the quality of life for people with disabilities and their families, meeting basic needs and ensuring inclusion and participation. According to many development scholars, it is estimated that CBR was initiated in the mid-1980s but has evolved to become a multi-sectoral strategy that empowers persons with disabilities.

But, despite the progress made in the past two decades, there are still millions of people with disabilities around the world, and thousands in the country, who do not receive basic rehabilitation services and are not participating equally in school, work, or social activities

According to David Werner formerly of Hesperian Foundation in Canada, CBRs' biggest strength is that it tries to reach all people with disabilities, especially those in greatest need. On the other hand, the Malawi’s National Policy on Equalisation of Opportunities for Persons with Disabilities emphasises that this strategy should be implemented through the combined efforts of people with disabilities, their families and communities, and the appropriate health, education, vocational and social and other related services.

Finally, it is also important to realise that, where properly funded and supported, CBR can make a significant contribution towards the implementation of the CRPD and achievement of the Millennium Development Goals (MDGs). Next week, we will therefore explain how CBR can become one small tool among many to help achieve the MDGs.