CBR is not a medical system

Publicerad: 2004-10-10

After 25 years of CBR there are still some people – for reasons that are unknown – who propagate the idea that CBR is based on a medical system. The reality is totally different:

a) CBR bases the training to overcome delay in functions using the family and community resources (such as self-help groups), all of this based on non-medical personnel. No medical diagnosis is needed (just a description of the problems) and medical treatment only advised for
conditions that require drug treatment (of for instance. epilepsy, tuberculosis, severe mental disease, leprosy) or surgery (for instance for cataract, severe deformities) or the provision of technical equipment such as orthopedic appliances, eye glasses and hearing aids that cannot be produced in the community.

b) the first step in setting up a CBR system is to create community committees with full representation for people with disabilities and for their families and ask them to plan for and then locally manage the programme. The WHO Manual right from the beginning ( published in 1979)
has a Guide for People with Disabilities giving them ideas about how they can create their own local organization. Strong support has been given to the empowerment of people with disabilities through peer support.

c) the CBR programme has taken the initiative to promote inclusive integration in all the programmes carried out

d) creating jobs using ability training in the community is a key point of CBR.

e) in reality the main protest against CBR has come from the medical professionals who felt threatened by the fact that CBR demystifies the technology and transfers the knowledge and skills to people and encourages them to do all that is possible themselves.

f) it is worth noting that the CBR strategy combined with a poverty alleviation and liberation programme has in a large number of industrialized countries lead to the dismantling of a medical-based programme in residential institutions, moving people with special needs to independent living in the community. In Sweden, for instance, these institutions were by end of 1999 all closed by law.

g) the Disability Action Group has recently (1996-2001) conducted eleven special 3-week seminars/courses on the Planning and Management of CBR for 130 participants from 70 countries. Other seminars/courses have been given in ten more countries and on regional basis. Lectures and other verbal presentations have over the years been given for audiences of more than 10,000 people. For those who have taken part in those or read the written material distributed, it should by now be evident that CBR is an effort to stress a common sense approach and not a strategy based on a medical system.

The Disability Action Group has a number of publications that should serve to explain the real situation. Before again making statements about CBR, which are totally unfounded, those concerned should examine the available written material, much of this has been widely disseminated.

Einar Helander