Integrating physical rehabilitation program with community based approach- A state initiative Rajesh Tiwari, Dep. Director, DSW, Govt. of Chhattisgarh, India Soikat Ghosh Moulic, AD-Technical, Mobility India, India 04-10-2013 FATO 2013-IVORY COAST 1
Today, more than 90 countries practice CBR: a common strategy in the developing world for rehabilitation and inclusion of people with disabilities 04-10-2013 FATO 2013-IVORY COAST 2
Realising CBR- A combined efforts of persons with disabilities and their families community members government especially local government non-governmental organizations/civil societies 04-10-2013 FATO 2013-IVORY COAST 3
Physical disability program and CBR- Challenges!!! Physical disability program- enhance mobility. preconditions for the next steps: human rights and development However, millions of people with disabilities have very limited personal mobility due to lack of access to mobility devices. Provision of mobility devices is usually a low priority area in Government policies and practices. Low awareness about the needs for and benefits of mobility devices are common, at all levels. 04-10-2013 FATO 2013-IVORY COAST 4
Common approach Physiotherapy Assistive devices Corrective surgery Education/schooling Accessible classroom and toilet Accessible environment Vocational training Income What to People need Income Food Clothes House Water and Toilet Education - School Treatment or Cure Calipers/Shoes Exercise Challenge- How to reduce the GAP between these TWO 04-10-2013 FATO 2013-IVORY COAST 5
What could be the reasons??? Definition and the process Relation among the stake holders. Awareness & educational poverty (education) Stigma and prejudice not visible/hidden (Social) Many do not survive long (health) Poverty (Income) 04-10-2013 FATO 2013-IVORY COAST 6
State of Chhattisgarh 12 years old Population- 25.5 million 10 th largest state in India Lack of sound physical rehabilitation program Affected by insurgency movement Existing DDRC program is not upto the mark- a huge challenge 04-10-2013 FATO 2013-IVORY COAST 7
State level consultation- Chhattisgarh To bring together all the stake holders under one roof. To come out with the common issues at different levels. Develop a strategy at state level to address the issues. Form a network with proper representationguide the state on linking physical rehabilitation program with CBR. 04-10-2013 FATO 2013-IVORY COAST 8
State level consultation- Chhattisgarh Stakeholders Persons with disabilities, parents Representatives from DPO s, NGO s Professionals like therapist, medical doctors, prosthetists and orthotists National institutions NMS of ISPO in India Organised by Department of Social Welfare, Chhattisgarh Govt. Supported by ICRC India 04-10-2013 FATO 2013-IVORY COAST 9
Objective of the consultation Help initiate dialogue between pwds/families, the grass root workers/ service providers, the professionals and policy makers- to provide rehabilitation service provision To develop a networked approach- facilitate empowerment of stakeholders in the program To support create an environment- empower the pwds to take informed decisions- right to choose. 04-10-2013 FATO 2013-IVORY COAST 10
Specific findings Awareness Evident lack of empowerment among pwds Not sure about the basic human rights Lack of awareness on state supported entitlements PWDs not clear about the government departments responsible and their functions. Poor quality of life!!!!! 04-10-2013 FATO 2013-IVORY COAST 11
Specific findings Capacity building- stake holders, service providers Very poor or almost missing Good programs in wrong hands- no assurances Adequate rehab professional at various levels missing- huge gap between pwds and service providers. No one is responsible- NOT MY BABY!!! 04-10-2013 FATO 2013-IVORY COAST 12
Points of discussion. How to empower communities and various actors and partners in the implementation of physical rehabilitation projects? Alternatives to the present situation. recommendations (strategy) for the operation of the coordination network. How to improve the existing physical rehabilitation program in the region 04-10-2013 FATO 2013-IVORY COAST 13
Expected outcomes Point 1- empowering communities Coordinated network approach to facilitate uniform discussion on related issues Workplace accessibility Employing pwds in employment exchanges- ensure right job for the right person Surveys to assess the present status- state responsibility Single window approach. 04-10-2013 FATO 2013-IVORY COAST 14
Expected outcomes Alternative to present situation Strengthening, capacity building of the existing referral system. Referral system to start from grass root level- social welfare department to ensurecoordinated cell Empowerment of grass root representatives- village heads, anganwadi workers, PHCs, parents of cwds and pwds. 04-10-2013 FATO 2013-IVORY COAST 15
Expected outcomes Early identification and intervention- anganwadi (preschool)workers, RTAs, MRTs, volunteers, Government entitlements- process made easyappropriate awareness at all levels Local transport- accessible, inclusive, sensitisation. State supported disability help line 04-10-2013 FATO 2013-IVORY COAST 16
Expected outcomes Network operating strategy Constitute grass root level committee including pwds, families, community members, SHG members Committee to act as redreasal forum to take up issues at block and district level State supported common meeting of representatives of all levels of stakeholderscommon issues- LEARN FROM EACH OTHER 04-10-2013 FATO 2013-IVORY COAST 17
Expected outcomes Improving the existing physical rehabilitation program Collection and dissemination of information on existing facilities in the region- stakeholders Effort- reaching out to those who cannot come to youdoorstep service provision Capacity building- training of local youth- take up maintenance and follow up activities at grass root level- state supported program. Reviving district rehab centres- state supported initiative 04-10-2013 FATO 2013-IVORY COAST 18
Way Forward Cross disability multisectoral approach Creation of 2 nd generation personnel- RTA, CBRW to coordinate and network with professional (health)- building community resources at all levels Capacity building of state supported grass root teachers, preschool(anganwadi) workers in early identification and intervention with proper referrals. With the TOP UP approach strengthen the BOTTOM UP principles. 04-10-2013 FATO 2013-IVORY COAST 19
Way Forward Persons with disabilities and the families need to be at the centre point. Service provision to provide the choices service users to make the CHOICE- APPROPRIATE TECHNOLOGY AT ITS BEST 04-10-2013 FATO 2013-IVORY COAST 20
ENSURING NOTHING FOR US WITHOUT US INFORMED CHOICES, DECISIONS AND CHANGES CREATING A BETTER TOMORROW- EVERY BODY IS RESPONSIBLE 04-10-2013 FATO 2013-IVORY COAST 21
Thank you FATO for this opportunity MERCI