Objectives of the training

• አካል ጉዳተንነት የሚከሰተዉ ብዙን ጊዜ ሰዉ ሠራሽ በሆኑ ምክንያቶች

ብቻ መሆኑ ታዉቆ ህብረተሰቡና ወላጆች አካል ጉዳት እንዳይደርስ
ሁሉም ዜጋ የበኩሉን ጥንቃቄ እንዲያደርግ ለማሰገንዘብ
• To over come attitudinal barriers and
appreciating differences ,mutual understanding
tolerance and helpfulness among all PWDs
• The aim of this course is to help you to bring about positive
change for disabled people in communities where you work.
To break down barriers between disabled and non-disabled
people. The course is: • designed to boost disability
inclusion in development programmes;
 Objectives
• To ensure that people with disabilities are able to
maximise their physical and mental abilities, to access
regular services and opportunities, and to become active
contributors to the community and society at large.
• To activate communities to promote and protect the
human rights of people with disabilities through changes
within the community, for example, by removing barriers
to participation.
• To capacitate local administrators and Professionals who
provide rehabilitation services have the responsibility to
provide relevant information to people with disabilities so
that they can make informed decisions regarding what is
appropriate for them.
 2 . Community Based Rehabilitation (CBR )
• 2.1 Concept of CBR
• CBR is a strategy within general community development for the
rehabilitation, equalization of opportunities and social inclusion of
all people with disabilities.
• CBR is implemented through the combined efforts of people with
disabilities themselves, their families, organizations and
communities, and the relevant governmental and non-
governmental health, education, vocational, social and other
services.
 Individual Models (cont’d) CSE-
Hawassa
• The medical model of disability:
• believe there is something “wrong” with
disabled people and so
• believe disabled people need to be
“fixed” (often medically) so
• they can be “integrated” into society and
participate according to the way society
is structured for the needs and desires of
non-disabled people.
 Individual Models (cont’d) CSE-
Hawassa

– Focuses on the impairment the individual person

has and sees it as an obstacle preventing them
from fully participating in society.
– The focus is to “cure” or “improve” individuals
with impairments in order to include or “fit”
them into society.
– In summary, the medical model perceives
disability as a problem located in the disabled
individual (assumes: working to “fix” or “cure”
individual can solve the problem).
 Individual Models (cont’d) CSE-
Hawassa

 The Charity Model of disability:

– Regards people with impairment as “unfortunate”,
“tragic” or “helpless” - people who deserve pity and
charity.
– The focus is to provide disabled people with money or
gifts, such as food or clothing.
 Also the this model regards, disabled people are long-term
recipients of welfare and support
 In summary, this model perceives disability as a problem
located in the disabled individual.
 Here the disabled person becomes defined only as a passive
recipient of long-term aid, gifts and other help, and not as a
citizen who can be a productive member of society.
 The social model (cont’d) CSE-
Hawassa
 Focuses on society,
 It recognises the inability of a society to
accept and accommodate all of its members
as it excludes disabled people.
 With this model or view, people are disabled
by society as they are deprived of rights and
opportunities due to their impairment.
 Types of Disabilities

According people and housing census there are over 25

different types of disabilities. The most common types of
disabilities are listed below
•people with a physical disability
•People who are blind or partially sighted
•people who are deaf or hearing impaired
•people with learning disabilities (Intellectual disability
•people with mental health or psychological difficulties
•People with Behavioral and Emotional disorder
•Language and communication Disabilities
•Who can be people with disability?
men, women, and children; employers and employees;
students and teachers; managers, civil servants and all
citizens.
 
 Ways to prevent disability
 Levels of prevention
 There are three levels of prevention
1.Primary prevention
2.Secondary prevention
3.Tertiary prevention
 Primary prevention-
- focus on avoidance of impairment from occurring.
- important for both people with or with out
disability.
 Levels of prevention cont.d
• Aimed at people e.g.immunization,safe water
supply,nutrition,good living and working
condition,etc
2.Secondary prevention-early detection and early
treatment of health conditions with the aim of
curing or lessening their impact.
e.g eye examination to detect cataract
appropriate handling of # bone to promote
proper healing
 Strategies of disability rehabilitation
1.Institutional based rehabilitation
–It is a way to be carried under residential rehabilitation
–Much expensive to undertake
–It was tried in Ethiopia in 1990’s but remained
unsuccessful due to it is much expensive
• It incurs much cost to undertake
• It requires trained manpower such as managers,social
workers,project officers,human resource personnel, it
needs residence, Establishing so many departments
• It lacks socialization
• It addresses few number of beneficaries compared to
CBR
• It needs higher budget to carry out the program
• This approach focuses on PwDs and gives little
attention to their families, communities and other
relevant social factors.
• The major shortcomings of institutionbased care
are probably its high cost and location (usually in
urban centres)
• Community involvement in these services is
usually very limited, thus increasing the costs per
person treated and promoting little social change.
 Community based rehabilitation
• This rehabilitation method has no alternative
• The service is delivered by community &
volunteers
• The service is delivered at the home of the
client where CwDs provided education,
counseling, economic, awareness raising,
health and psycho social support services
 Strength side of CBR

• The service can be addressed to wider community

• It empowers the community and parents of CwDs in
particular
• It can address so many beneficarieswith little
budget/resource(Cost effective way
• It can easily transfer knowledge and skills to the community
and parents of CwDs at large
• It provides comprehensive rehabilitation
• its program activities can be adressed too many stakholders
• It can ensure sustainability.
• It can be easily carried out with the help of local knowledge
and resources.
• It encourages volunterisim for effective implementation
• It can involve participates different groups of the population
 Weaknes of CBR

• Limited participation and contribution from communities

• Poor education and communication activities to involve the
communities
• Lack of social equality for disabled people
• CBR project management not working steadily and carefully
• Cooperation between local level authorities not properly
planned
• Lack of coordination among stakeholders often leading to
misunderstandings and, eventually, to the interruption of all
CBR activities
• Research, information, planning, monitoring and evaluation
neglected.
 Types of rehabilitation
• Physical rehabilitation
– Provision of assistive devices both in the center and
at the outreach sites)
– Provide education on proper use of appiliances
- Toileting
- Eating
- Dressing Activity of
- Washing daily living
- Feeding
- Prosthesis-Artificial limbs
• Orthosis: AFO.KAFO,HKAFO
 Challenges in the area of Education.
• Educating PwDs is generally considered unnecessary
by their families.
• When families do show interest to educate CwDs practical
barriers (such as distance and inaccessibility of school
infrastructures) emerge.
• Difficulties in motivating school teachers to include children
with disabilities in their classes, and in persuading children
themselves to stay in school.
• Informal education was not really considered an option for
persons with disabilities, however, currently not accessible.
• children with disabilities could go to the nearest special
needs school
• Provision of educational
• Solution support
• Promote inclusive education
• Meet the diversified needs
Challenges in the area of Social Promotion and Inclusion

• It is difficult to bring persons with disabilities “out of

their homes” and to involve them in social events, such
as bag meetings,churches, small festivals of culture and
sports.
• A few had tried to encourage them to play music or
perform other forms of art.
• There need an attempt to raise awareness about
disability on the International Day on Disabilities or on
other occasions when the big population gathered.
• There need to facilitate opportunities for social contact
and gatherings are very limited .There need to involve
persons with disabilities in the community’s social life.
 social rehabilitation
• Social rehabilitation
– House to house visit
– Counselling
– Coaching
– Sign language training
– public awareness through community training
 Types of rehabilitation cont..d
• Economic rehabilitation(Livilihood support and vocational skills)
– Singer sewing
– Shoe repairing
– Computer literate
– General machine
– Dairy farming
– Electronic maintenance and instalation
– Wood work
– Hair dressing
– Photographing
– Petty trading activities
 Challenges in the area of Livelihood

• The experience of supporting persons with

disabilitieswas generally low
• Parents of CwDs claimed they did not know what
they were expected to do to support persons with
disabilities in terms of economic empowerment.
• Government stakeholders were not interested in
increasing employment opportunities and economic
independence for persons with disabilities
 Challenges in the area of Empowerment.

• Persons with disabilities explained in their own

words the importance of bringing disability issues to
the attention of the authorities and advocating for
them.
• They mentioned the importance of making persons
with disabilities more active, and of providing them
with psychological support, in order to give them
confidence and reduce fatalism.
• They claimed they had not been trained to
communicate directly and effectively with persons with
severe sensory (visual, hearing) or intellectual
disabilities, and therefore could not fully understand
their needs and support them effectively.
 Empowerment and inclusion.
• Empowerment is when an individual or a group of people begin to understand
that they alone, along with others, have the power to change a situation(to give
somebody a greater sense of confidence )
• አንድ ሰዉ አእምሮ ጎለበተ ወይም አቅም ፈጠረ ሲባል ሲባል እራሱንና በዙሪያዉ ያሉ ሰዎችን
በማስተባበር አካባቢዉን እንደሁኔታዉ መቀየር ሲችል ነዉ
• In many instances, people may need support, for example, in enabling people to
change their mindset (facilitation),
• ሰዎች ከአጉል ወይም አሉታዊ አስተሳሰባቸዉ እንዲቀየሩ የምናደረገዉ ጥረት የአሰተሳሰብ
ለዉጥ መቀየር ሥራ ማመቻቸት ይባላል
• providing information in a manner that people can understand easily
(dissemination)
• ለሰዎች በቀላሉ እንዲረዱት እና የአሰተሳሰብ ለዉጥ እንዲኖራቸዉ የሚደረግ ሥራ መረጃ
ማሰራጨት ይባላል፡፡
• and the means to use the information
(capacity building).
• ሰዎች የሰሙትን እና የተረዱትን መረጃ ጥቅም ላይ
ሲያዉሉት አቅማቸዉ ተገነባ ወይም capacity
building አደረጉ ይባላል
• This means may include training, money,
materials, counseling, motivation,
infrastructure, psychosocial and rehabilitative
services, etc.
 Smmary Notes
• Understanding community needs;
• Identifying community perceptions and beliefs;
• Promotion of social integration;
• Transferring knowledge to communities but also learning
from the communities;
• Empowering PWDs and community;
• Encouraging PWDs reach their potential, mobility etc.;
• Removal of physical barriers, social and physiological;
• Building strategies for sustainability;
• Changing negative attitudes;
• Addressing human rights issues and information sharing,
asessential components of the CBR programme
 Basic treminology
- Quadriplegia- paralysis of all four limbs
- Diplegia
• paralysis of corresponding parts on both sides of the body, typically affecting the
legs more severely than the arms.
Body parts involved:
- partially the trunk
- lower limbs
- not so much to the upper limbs
- Hemiplegia
Affect one side of the body
Additional impairments:
- visual-spatial problems
- Speech-problems (right hemiplegia)
- Anosognosia (left hemiplegia)