CBR News

The community based rehabilitation (CBR) program in UPMRC was established in the mid 1980s, mainly relying on the PHC set of services offered by UPMRC in the different regions.

Community participation and activation have been major pillars in the building of PHC networks by UPMRC. The CBR Program adopted its community-based approaches on the basis of this experience, going beyond the limits of the curative biomedical approach, represented by the prevailing then model of physiotherapy services, to adopt a community-based approach towards rehabilitation, making social integration of disabled persons a major goal for the rehabilitation process.

The CBR Program has been developing steadily within the overall growth and expansion of UPMRC in terms of links to the community and wider coverage by services

The CBR Program has witnessed a notable progress in terms of its philosophy, tolls and coverage.

With the outburst of the national Intifada in late 1087 and the emerging new needs for rehabilitation services in view of the large number of injuries sustained during confrontations with the Israeli occupying forces, UPMRC sought to respond to these needs by increasing its activities in the field of rehabilitation.

Within a short period of time, the CBR Program was able to cover a wide geographic area with a population of about 300,000.

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Community Based Rehabilitation (CBR) Ramallah Area

The community based rehabilitation program (CBR) in Ramallah area was initially launched in 1998 as a joint project between Palestinian Medical Relief Society and Star Mountain. The two organizations are complementary to each other in terms of their expertise and infrastructure in rehabilitation. Both partners adopted the concept of CBR as the framework for new strategies and projects on the primary as well as on the secondary level.

The joint project is active in five villages in the north eastern part of Ramallah with total population coverage of 12000. The villages are: Turmussayya, Abu-Falah, Al-Mughayer, Sinjel and Jilijlia.

The CBR program follows a community based approach to disability; rehabilitation was seen as a tool to improve the capabilities of the disabled for independent living. The overall objective was to promote a full social integration of disabled persons into their own communities.

The programs activities were initially modeled on the findings of the door to door survey, in which comprehensive data were collected based on the needs of the disabled persons and their families. The study focused on core activities of daily living (ADL) and requirements for social integration. In this context, indicators were devised to assess and evaluate the progress of the rehabilitation work. During the planning and research period, the program was able to contact all disabled persons in the communities and all relevant actors were involved in the planning and implementation process according to the needs of the disabled persons and their families in their own communities.
  

The program is part of the nationwide efforts to base all rehabilitation work on local structures to emphasize awareness, participation and education of the community and human rights and developments for all people with disability.

Nationwide, there are many deficits and unsolved questions about the nature of necessary services and possibilities of social integration for persons with mental disability. Therefore, the program is establishing a new model in dealing with this specific group which is often neglected even in the CBR structure. This model is based on the accumulated professional experience in special education and rehabilitation.

The basic part of the CBR work is based on home visits to the disabled person because working with the person in his or her own surrounding gives a better perspective of the need in which he/she needs to be rehabilitated. Prevention is also an important aspect of the work in this program, aiming at both preventing disabilities and preventing further complications for persons with already existing disabilities.

Since the CBR program is a community-based program, it finds itself in the recent situation of the Intifada dealing with different groups other than disabled people, like children, women and elderly, in view of the increasing needs for rehabilitation.
 

The main objectives of the program are:

• Change the community perceptions toward disability and create a new and positive community outlook (changing attitudes).
• Transfer knowledge to the community through community education and other activities.
• Improve the quality of life of the disabled people by maximizing their independence and self reliance.
• Promote the policy of early detection and early intervention.
• Promote school mainstreaming for disabled children in the area.
• Mobilize the local community through their engagement and participation in the program’s activities.
• Strengthen the capacity of the program through continuing education for the team (formal and informal training).

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Community Based Rehabilitation (CBR) Program in Jenin

Background:

This program was established as a result of great efforts made by the partner organizations, with support from the Swedish Diakonia, to meet the needs of the increasing number of disabled persons associated with the injuries of the first Intifada of 1987. At that time, Palestinian rehabilitation institutions were unable to accommodate the needs of such large number of injured persons for rehabilitation.

This Program is the first CBR program in the northern part of the West Bank. The Program's staff, consisting of 30 CBR workers and administrators, were trained in cooperation with Birzeit University Community Health Department.

The Program seeks to ensure the rights of disabled persons to be socially integrated within their communities and lead a decent life in line with principles of the International Declaration of Human Rights and the provisions of the Palestinian disability law No 4 of 1999. This aim is pursued through the involvement of community resources and capacities in the rehabilitation of disabled persons and a comprehensive view to disability issue as a public concern.
  

Disability prevalence:

The prevalence of disability was found to be 2% of the total population. The program classifies disabilities according to internationally accepted classifications as follows:

• Seeing difficulties
• Movement difficulties
• Speech difficulties
• Hearing difficulties
• Feeling difficulties
• Epilepsy fits
• Mental disorders
• Multiple difficulties

General objectives:
The main goal is to reach the largest possible number of disabled people in their direct environment to meet their needs with reliance o community resources ad community involvement, seeking to promote social welfare and achieve full social integration of persons with disability within their communities.

Objectives:

1. Achieve social integration for disabled persons in all life aspects.
2. Ensure equal opportunities, social justice and protect human rights.
3. Improve the quality of life of the disabled people by maximizing their independence and self reliance.
4. Change the community perceptions and attitudes toward persons with disability and their rights.
5. Promote the policy of early detection and early intervention and link CBR with PHC activities.

Program's services:

1. Home visits to disabled persons and training of family members to improve their skills and abilities to participate in the family and social life.
2. Preventive activities: tests and education aimed at early detection of disabilities.
3. Community activities: including community education on the rights of disabled persons and their social integration.
4. Capacity building: Including ongoing education for the staff and regular training sessions for volunteers from the local communities on CBR, voluntary work, rights, gender, democracy, psychosocial support, and self organization of disabled persons.
5. Coordination and networking with local institutions on rehabilitation and disability issues.
6. Psychosocial support to disabled persons and their families.
7. Community surveys in all the villages of the area on disability, as well as other studies and research related to the Program.