Rehabilitation Based on the Community

The rehabilitation process through RBC links and maintains any responsible social sector.

Through the program „Rehabilitation Based on the Community„, we count on a methodology of communal intervention, in which a multi- and interdisciplinary team participates, which is made up of professional in the issue of disability, local, trained personnel, students and volunteers from different countries.

RBC signifies a practical and compromising formula to bring our service and our accumulated experience of 20 working years in the fields of integral rehabilitation to a growing number of persons, who have any type of disability.

The RBC program stimulates the creation of local rehabilitation instances in each of the communities, associated to the program, through recruitment, training and supervision of local rehabilitation promoters.

These promoters are persons from each locality and could be persons with any disability or their family members, students, technicians, professors in health, catechists, as well as others volunteers collaborators. Also, public authorities and religious leaders are participating.

Background

Piña Palmera started to work with rural communities, close to the Center, in 1990. At that time, simple rehabilitation techniques were applied, basing on the book “Disabled Village Children„ from David Werner (published by the Hesperian Foundation).

The personnel in the region, which was trained by Piña Palmera, was in charge of the rehabilitation. They visited the houses where somebody with disability lived, but the rest of the community wasn’t involved.

In the year 1994, we decided to initiate the program “Rehabilitation Based on the Community„ (RBC) in the villages which we are working with, because the rapidly increasing amount of users exceeded our capacity to attend them.

As reference, we used the manual published by the World Health Organization. The basic idea, to which our program is geared, is to multiply the instances of rehabilitation by training and supervising local promoters, who, trained one time, can function as trainers of any of the members, who present any problem of disability.

With them, it’s not just feasible to turn to embrace to almost the totality of the disabled population in the area, but to decrease rehabilitation costs, given that, besides, the majority of the promoters are working voluntarily, and, even more important, the rehabilitation is gradually assumed as a communal responsibility.

Thanks to the initial experiences we had, until today, we could have developed efficient criterions and guidelines for our work in new communities.

Definition of RBC

According to the World Health Organization WHO, “this term covers all situations, where rehabilitation resources are available in the community. This process implicates the transfer of knowledge, as to disability and rehabilitation activities, to persons with disability, their families and community members„.

It implies also, according to the WHO, the communal participation in planning, decision taking and program evaluation. This method could be called as the democratization of rehabilitation.

(Taken from the manual “Communal Training for Disabled Persons„ from the WHO 1989)

RBC methodology

For us, RBC is a methodology of communal work for persons presenting any disability, in which participate:

• The disabled person and her family

• Local authorities

• Other sectors (teachers, doctors, clergy)

• Local promoters, who receive training and supervision from therapists of C.A.I. Piña Palmera.

• A multi-disciplinary team, which is made up of language therapist, physical and occupational therapists, one social worker and one anthropologist.

Our communal intervention model resulted of interests and needs manifested in the local population. Working issues and times mark each community. We are working directly with families, teachers, specialists and local authorities. In the communities, where other languages are spoken, we use local translators.

Every community has its cultural, social and political specialties, to which we adapt our work. Form and grade of intervention is derived by the participative diagnose (and/or by diagnose by observation).

We get this during the first reunion we assist, where we detect jointly particular needs and interest, and where practical and flexible solutions are suggested, which we approach afterwards by giving courses and support.

The RBC model of C.A.I.P.P.A.C.

The ulterior objective of our communal intervention model is to achieve the physical and social integration of disabled persons and their families into active life of the community. This covers following areas:

Kommunale Diagnose:
Recognition of the conditions of persons with disability in each community, of existent services (doctors, teachers, technicians, etc.), communication possibilities, transport, local culture, local economy, working sources, etc. During a visit to the community, in which the team of Piña Palmera makes an initial reunion with in the program interested persons and with local authorities, diagnose is made.

Sensitization:
Sensitization workshops are carried out with local authorities, medical personnel and representatives of the community. This workshop takes about four hours, in which the participants simulate different disabilities. Afterwards, the workshop is reflected by certain questions close to the experience.

Conformation of the communal support network:
Here participates the health council, medical personnel, disabled persons and their families, teachers and religious representatives.

Each sector has its precise responsibilities as to the program: making censuses in the ranches, citing reunions with beneficiaries and their families, organizing space to carry the rehabilitation out, making references to hospitals, creating files, exhibiting training needs or integration problems etc.

The training of local promoters and/or of family members of persons with disability is the responsibility of the team of Piña Palmera. They are carried out in the communities, according to the attended disability.

Supervision of the therapy program:
The therapists of Piña Palmera evaluate, jointly with the promoters, the rehabilitation efforts, the needs of adaptation of seats and other supports.
Integration and recognition of abilities – social, scholastic and labor integration, according to the case, is the responsibility of the RBC team, too.

Evaluation:
The program is evaluated every six months by the community.

How do we carry the RBC program out?

To initiate the RBC program, the community needs to expound the necessity, for example by a parent, a student, a teacher, etc. The conditions of the community and the interest, showed by the local authority to the program, are decisive.

The team of Piña Palmera visits the community in order to diagnose the situation, jointly with the community and their authorities. The workshop for sensitization is given also.

In this program are local materials used for therapy, the working place is simple. The most important thing is though, that the people of the community involve themselves in the program and that the program is assumed as their own to give to the activities the continuity necessary.

The program rises from the communities’ needs; it develops in the community and transforms the conditions, according to culture and local propositions.

Local Promoters

Who are they?
They are persons from the same community. They could be a mother of a disabled person or another family member, or a student who is fulfilling his social service, a teacher, a catechist, or any interested person.

What do they do?
They train family members of disabled persons, so that they can carry the proponed rehabilitation program out.

They coordinate activities, which are conducive for the integral rehabilitation, together with competent local authorities.

They coordinate integral rehabilitation programs, together with specialists of Piña Palmera.

The therapists of Piña Palmera

What do they do?
They train promoters in basic rehabilitation practices.

They elaborate working plans, related to the rehabilitation of disabled persons, jointly with the local promoters.

They advise the promoters with particular emphasis on physical and social integration of the users.

They attend to users with special requirements, and channel them to corresponding instances: hospitals, centers for special attention, etc.

They give continuity to the implemented rehabilitation programs.

They supervise and evaluate the promoters work.

The RBC coordinator

In addition to therapists and specialists of integral rehabilitation, the RBC has a coordinator. She is in charge of the total implementation of the program.

To her tasks pertain:

To arouse the community’s interest in integral rehabilitation, and to involve it in the program in the most participative and ample way.

To advance the conditions in the community, which permit the correct implementation of the program.

To develop programs of sensitization and social integration, to favor the incorporation of disabled persons in communal life.

To support initiatives and administration of the local promoters due to the integral rehabilitation of affected persons in the items: education, labor, health and social life.