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  » COMMUNITY BASED REHABILITATION  
 

  

 
 

The formal name is CBR.
We consider it our faith and philosophy.

Some call it strategy to reach the largest number of people at the lowest cost in the poor countries. Whatever it might be, a strategy or an ideal, it has given professionals and people like us, committed to the issue, an opportunity to look at and think about the problem a little differently.

A group of young men, who had neither any professional nor any technical background, started off Pratibandhi Kalyan Kendra on its journey 29 years ago. All they had was a commitment to social change.

PKK had a modest beginning as a school for deaf children with only six children and one trained teacher and a monthly budget of Rs.170 (US$ 3) But our institutional services led to phenomenal growth during the seventies and eighties of the last century. 

 
 


Over a period of time PKK felt the need to work in the semi-rural areas of Hooghly, because people from rural areas could not access urban facilities. By the mid-eighties we realized that people living in remote rural areas find it difficult to access institutional facilities even at the district head quarters. To make its services more widely accessible, PKK began its Community Based Mobile Audiology Clinic for early identification of deafness and intervention at the village level. 

The expansion of its activities in rural areas has brought home to us the painful reality that only 20 per cent of the existing facilities are available to 80 per cent of our people, who live in rural areas, while the remaining 20 per cent, the middle and upper classes living in urban areas enjoy 80 per cent of all available facilities. This disparity exists in every sector (health, education, social welfare), including disability. 

Professionals monopolize and control all information, knowledge and expertise and these are not made easily accessible to the general public.

These observations, born of experience, provided new lessons and space for introspection. We had to think afresh of our approach and activities. A major change took place. We comprehended the need for CBR for all categories of disabilities. PKK had to go beyond an alternative service delivery system. An entirely new philosophy of action was required. The philosophy of a movement to educate and unite people with disability and motivate the community to take charge of their lives. 

We realized that our limited strength would confine our reach only to a handful of children. We, therefore, decided to develop a three-tier structure for promoting CBR and to involve partner groups at Block and village levels. 

Today PKK conducts its CBR activities in Orissa in partnership with 'Action Aid India'. In West Bengal PKK conducts these activities through partner organizations in collaboration with 'CRY'. It works with more than 800 children and their families to help them achieve a better future. 
 
 
COMMUNITY BASED REHABILITATION - ORISSA :
 

 
 

The Orissa chapter of PKK was started in early 1990. One of its old partners, Oxfam (I) Trust, an UK based charity, invited PKK to work in Orissa to share its experience and expertise with others.

PKK has thus extended its operations to this neighbouring state. Initially, we confined our work to clinical and educational activities through an institutional approach, in Bhubaneswar. Later, we shifted our activities to the neighbouring Block — Balianta — and started working, through a community based approach. in 20 villages with 100 children with all types of disabilities 
 

 
 

Currently, in collaboration with Action Aid India, our work for bringing about long-term social change has expanded to 97 villages, covering the entire Balianta Block of Khurdah District, with a population of 97,000. Action Aid India, a UK based charity, has been working in India for more than 25 years for long term social change of marginalized people. PKK’s partnership with Action Aid was initiated in mid- eighties to support few marginalized children through institutional programmes in West Bengal. The present collaboration has been made in 2000, for a long term change of conditions of children and persons with disabilities in Balianta Block of Khurda district

In all these years, in all our work we have experienced the marginalization of disabled children by the society. We have come to realize that lack of proper education is the root cause of this attitude. 

When we initiated our programme, we found that many of the families had no clear understanding of the nature and degree of disability of their children. They had no idea of where to go, what to look for. 

Some of the parents tried to explore different ways to help their children, but for various socio-economic reasons there was no significant change. The experience of many of them with some urban-based and institutional programmes was frustrating. That generated mistrust and a negative attitude.
 
PKK aims to fight to end this social indifference and establish equal opportunities for one and all, A major focus of our work is the conscious promotion of social inclusion of children with disabilities. We work within the community with a dream to create a society, which will become sensitive enough to shed age-old superstitions and taboos, accept children with disabilities on equal terms and ensure equal opportunities, rights, involvement and ownership for them as a way of life.

Key issues and agenda in CBR activities

Inclusion 
Inclusion of Children and People with disabilities in all educational, social, cultural, political and economic programmes at all stages and levels. In order to ensure their significant involvement, their distinct decision-making roles should be encouraged and emphasized.
 
Access 
Promotion of barrier free environment to ensure that children and people with disabilities can have easy access to all public buildings, programmes and services. Also enhancing the access to information, government facilities and concessions.
 
Rights of the persons with disabilities

Implementation of The Persons With Disabilities ( Equal Opportunities, Protection of Rights and Full Participation) ACT, 1995, The National Trust for the Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities Act, 1999 ,The Mental Health Act, 1987 .

Development of people’s organization as stake holder

Promotion of an organization of 600 people, with and without disabilities, as stake holder of the programme and finally developing a Block level registered body to carry out all activities, that would be initiated by PKK in future.

Strengthening the capacity of children and persons with disabilities

Provision of various services to strengthen the capacity of the children and persons with disabilities, to enable them to raise their voices, to fight for their rights and also to contribute for social changes for all.
 
 
Activities 
We carryout our CBR activities in five major components

1. Community capacity building

 

 
 

We are in the process of forming an inclusive three-tier community group who would finally act as the stakeholder of the programme. The three tiers consist of Village level, Panchayat level (sector level) and Block level groups of persons, with and without disabilities. Each group consists of :

  • Four persons with disabilities, among whom two would be women
  • Parents of four children with disabilities
  • Two teachers of local schools 
  • Two Anganwadi workers from ICDS
  • One ANM worker
  • One village leader
  • One local club member
  • One village level businessperson
  • One representative from Panchayat (Local Government)

 
  2. Addressing immediate special needs of children and persons with disabilities
 
 
 
To make provisions for functional rehabilitation services

Provision of special services to overcome the disability or minimize the effects of their functional limitations does not exist in the Block. Therefore we have formed a team of professionals, external consultant and CBR workers to address the areas of :
 
 
  • Identification of children with disabilities in the community
  • Assessment of degree of impairments
  • Arrangement of corrective surgery and medical intervention
  • Arrangement of aids and appliances to enhance the residual capacity 
  • Training, orientation and transfer of skills to parents 
  • Arrangement of education of children in the local schools and center run by ICDS
  • Arrangement of training at home for children who have severe disability
  • Addressing the issues of scholarship and stipend and other benefits 
  • Arrangement of vocational training of adult persons with disabilities
  • Linkage with financial institution for loans and other benefits
  • Run special programme for children with epilepsy
  • Arrangements of therapeutic support
  • Developing a unit to manufacture and repair aids and appliances
 
 
  

 
3. Influencing policies and collaborative alliances

To promote inclusion and access in the areas of Education by -


Interacting and collaborating with District Inspector of schools, DPEP, ICDS for promoting inclusive education.

Organize raining programmes for the heads of all primary schools in block to promote inclusive education in the project area, We have so far sensitized and trained 200 teachers in the block

Conducting training and orientation programmes for Panchayat functionaries (local governance) for inclusion of children and persons with disability in all rural development and poverty alleviation programme.

Publish materials on RIGHTS of persons with disabilities
 
 
  
 
  4. Resource generation  
 
 
 

Generation of all round resources locally, regionally and nationally for strengthening the process and activities of Community Based Programme in Balianta Block.. These resources would be in the form of commitment, understanding, volunteerism, expertise, skills, finance, public opinion and markets.We use various resource mobilization mechanisms and powerful communication tools. 
 

5. Gender Equity and Empowerment programme 

  • Promotion of non- discriminatory parental attitude
  • More access of women with disabilities to education and training
  • Create specific employment programme for women with disabilities
  • Awareness on abuse and harassment 
  • General awareness on women with disabilities
 
 


We have been promoting awareness amongst parents, caregivers, panchayat and women’s group about the special need and difficulties of girls and women with disabilities for reducing discrimination and incidents of physical, emotional and sexual abuse.
 
Special inputs for education and support to women with disabilities have been extended by us to come forward and form a group. To strengthen the process we have been forming small groups with women and running technical training centres to enhance their skills.

 
     

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