By Jorain Ng
Let’s have a show of hands – who has heard of the term ‘community based rehabilitation’?
If this is your first time coming across the term, do not fret – I was in your shoes. Before I participated in the regional workshop on community based rehabilitation, I have never heard of this term. And this is not surprising because CBR is not included in Singapore’s policies and programmes for persons with disabilities, and CBR was never discussed or even mentioned in the conferences, workshops and talks on disability I have attended.
When the time came for me to interact with other delegates and distinguished speakers who have had immense experience in CBR, I felt like a fish out of water. Not only did I learn that CBR is a well-known concept and is included in the national policies of some ASEAN member countries, I also learned that CBR is recognised to be the most appropriate strategy for inclusion for ASEAN countries. I had to do a double take. Hold on – isn’t CBR just about rehabilitation? Why is it so important to these ASEAN countries?
Here are some lesser-known facts about CBR:
CBR is not just about rehabilitation.
Don’t be fooled by the name. CBR is not just about rehabilitation. In fact rehabilitation is just a small part of what CBR does now. According to the World Health Organisation’s guidelines, CBR consists of five main components, namely, health (therapy, rehabilitation etc), education (early childhood intervention services, higher education etc), livelihood (waged employment etc), social (marriage and family, culture and arts etc) and empowerment. At its most basic, CBR is about meeting the basic needs of persons with disabilities.
CBR is all about empowerment.
The empowerment of persons with disabilities, their families and communities is at the center of CBR. A good CBR programme is not implemented from the top-down; it actively involves persons with disabilities and their family members in the decision-making process, and is tailored to the needs of persons with disabilities.
CBR as a concept varies across and within countries.
In some ASEAN countries, the CBR programmes only focus on health such as rehabilitation, disability prevention and assistive devices. While others focus on all aspects of life such as health, education, social and livelihood. There are also varying perspectives on the role of the Government in CBR. Some countries have argued for greater Government intervention.
Malaysia is the leading country in CBR.
Among the ASEAN member states, Malaysia is the leading country in CBR. Not only do they have a concrete national CBR policy, Malaysia has a CBR network that provides training for CBR personnel. CBR staff is also a recognised profession in the country.
CBR is more appropriate for developing countries.
CBR is designed mostly for developing countries where there are limited access to disability-related services and programmes, especially in rural areas. Governments in these countries lack the necessary resources to provide services and programmes for all persons with disabilities in both urban and rural areas. CBR help fill this service gap by mobilising resources in local communities in terms of manpower, material and money.
Singapore’s small geographical size and relatively high level of development mean that most disability services and programmes are located close to people’s homes and are available at local community centres. Moreover, the Government provides extensive funding for voluntary welfare organisations providing disability services. Hence CBR is not the most relevant initiative for Singapore.
Even so, there are lessons Singapore can learn from the CBR initiative. In these developing countries, CBR serves as a guiding principle or framework for the formulation and implementation of disability policies and programmes. Singapore can take a leaf out of this CBR initiative, and be clear about the philosophies or guiding principles underpinning the many disability policies and programmes. And by that I mean having a clear understanding of the concept of disability and the social model of disability. (Hang on – what is the social model of disability again? Please read DPA’s booklet on inclusion.)
CBR is a strategy for inclusion.
CBR guidelines adopted the same principles listed in the United Nations Convention on the Rights of Persons with Disabilities (CRPD). The goal of CBR is to ensure that persons with disabilities have equal rights and access to the services they require to attain and maintain maximum independence, and achieve full and equal participation in all aspects of life. As such, most ASEAN countries view it as the way forward and the most appropriate strategy for inclusion.
Singapore’s alternative to CBR and method of realising the objectives of the CRPD is an action plan called the Enabling Masterplan. It is essentially a list of concrete and comprehensive recommendations to improve the lives of persons with disabilities in Singapore. The Singapore government also translated CRPD obligations into locally-appropriate policies and programmes. (For more information, please read DPA’s booklet, Singapore and the UN CRPD).