Promoting Disability Sector in Rural Cambodia: Community Based Rehabilitation [CBR]
Community based rehabilitation (CBR) promotes collaboration among community leaders, people with disabilities, their families, and other concerned citizens to provide equal opportunities for all people with disabilities in the community. The CBR strategy, initiated two and a half decades ago, continues to promote the rights and participation of people with disabilities and to strengthen the role of their organizations (DPOs) in country.
In recognizance of the importance of Community Based Rehabilitation, the Disability Action Council (DAC) has jointly started with the Ministry of Social Affairs, Veterans, and Youth Rehabilitation (MoSVY) to establish a Project Steering Committee to coordinate and implement a one year pilot program of the Community Based Rehabilitation program in the country. The committee is headed by H.E. Sem Sokha, Under Secretary of State of MoSVY, with technical assistance of DAC and involved NGOs, Funding Agency officer, and DPOs. The program, which gains financially support from UNICEF, has been in operation in 8 provinces throughout the country. These provinces are Kampong Chhnang, Pursat, Svay Rieng, Banteay Meanchey, Battambang, Siem Reap, Kampong Cham, and Prey Veng.
The purpose of the project is to coordinate the community based rehabilitation, which is currently being implemented by the DPO implementers at the local levels, to make sure that persons with disabilities, women with disabilities, children with special needs, and marginalized groups of all ages have access to rehabilitation services, and increased equalization of opportunities as they are entitled to. It is noted that CBR is implemented through the combined efforts of people with disabilities themselves, their families, organizations and communities, and the relevant governmental and non-governmental health, education, vocational, social and other services.
CBR approach
It is noted that CBR is implemented through the combined efforts of people with disabilities themselves, their families, organizations and communities, and the relevant governmental and non-governmental health, education, vocational, social and other services. The major objectives of CBR are:- To ensure that people with disabilities are able to maximize their physical and mental abilities, to access regular services and opportunities, and to become active contributors to the community and society at large.
- To activate communities to promote and protect the human rights of people with disabilities through changes within the community, for example, by removing barriers to participation.
Disability and Rehabilitation
Disability is no longer viewed as merely the result of impairment. The social model of disability has increased awareness that environmental barriers to participation are major causes of disability. The International Classification of Functioning, Disability and Health (ICF) includes body structure and function, but also focuses on activities and participation from both the individual and the societal perspective. The ICF also includes five environmental factors that can limit activities or restrict participation: products and technology, natural environment and human-made changes to it, support and relationships, attitudes, and services, systems and policies. No nation has eliminated all of the environmental barriers that contribute to disability.
Rehabilitation services should no longer be imposed without the consent and participation of people who are using the services. Rehabilitation is now viewed as a process in which people with disabilities or their advocates make decisions about what services they need to enhance participation. Professionals who provide rehabilitation services have the responsibility to provide relevant information to people with disabilities so that they can make informed decisions regarding what is appropriate for them.
Essential Elements of CBR
CBR requires community and DPO involvement. But communities and DPOs cannot work alone to ensure equal opportunities for people with disabilities. National policies, a management structure, and the support of different government ministries, NGOs and other stakeholders (multi sectoral collaboration) are also needed. Country approaches to implementing CBR vary a great deal, but they have some elements in common that contribute to the sustainability of their CBR Programs. These include:- National level support through policies, co-ordination and resource allocation;
- Recognition of the need for CBR Programs to be based on a human rights approach;
- The willingness of the community to respond to the needs of their members with disabilities;
- The presence of motivated community workers
Allocation of Resources
National resources can be allocated to CBR in a variety of ways. One is the direct allocation of funds to support aspects of the CBR program, such as training or the strengthening of support services. Another method is to include a disability component in all developmental program initiatives especially in aiming at poverty reduction strategy Programmes. Government can also encourage NGOs, businesses and the media to support CBR.National Coordination of CBR
In Cambodia, the Project Steering Committee was established to take lead the Community Based Rehabilitation Program (CBR). The members of Committee comprised the representative of the Ministry of Social Affairs, Veterans, and Youth Rehabilitation (MoSVY), NGOs, DPOs, and National Semi Autonomous Coordinating Body (DAC) and donors.
So far, this UNICEF funded pilot program has been in operation in 8 provinces since June 2006 and it will end in July 31, 2007. Currently, Disability Action Council Secretariat of the PSC, has actively been negotiating with the UNICEF to achieve financially funding support for the continuation and implementation of a new phase of the Community Based Rehabilitation in an expanded area all over the country.
Recommendations
- CBR will not work if the sectors mentioned above work in isolation. The following example illustrates the types of collaboration that can work well;
- Because CBR belongs to the community, representatives of the community must be involved in the planning, implementation and evaluation of CBR Programs;
- The Collaboration among all of the sectors that support CBR is essential. This is particularly important at the intermediate/district level where referral services are provided in support of community efforts;
- It is very important for all ministries, as well as non-governmental organizations to work in partnership. Although one ministry provides the organizational structure, all sectors play an important role in ensuring that the communities participating in the CBR program have access to support services and resources;
- There is also a need to expand CBR to areas to reach people with disabilities living in slums. New settings may also include locations where the community is not well developed. Even in these settings, community leaders may be identified and encouraged to make the needs of their groups known. These groups will include people with disabilities, who may be identified for rehabilitation services, but who are not sharing in other programs provided for refugees, such as skills training and placement Programs;
- The support service that considers the holistic needs of the persons, and not just the focus of its own service, is more likely to collaborate with other services. The Collaboration with other resource groups in the community is necessary because government services alone cannot provide women and men with disabilities with employment or social inclusion;
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