EDITOR'S COMMENT

The successful conduct of the recently held first Asia Pacific CBR Congress in Bangkok was a matter of pride, not just for the organisers and participants, but for all practitioners and promoters of community based rehabilitation in the region. Along with Africa, which has already held 3 such conferences, the Asian region has been witness to the initiation, growth, changes and maturing of CBR over the past 2 decades. The Asian Congress can be viewed as the culmination of the combined efforts of stakeholders in the region to consolidate and strengthen what is probably the most significant development over the last thirty years for people with disabilities, especially for those living in rural areas in developing countries.

The term 'CBR' is now well recognised, and is perhaps the only 'brand name' that has survived for such a long time in the development sector. This is reflected in the 2004 joint position paper of ILO, UNESCO and WHO, the WHO CBR Guidelines under preparation, and the UN Convention on the Rights of Persons with Disabilities that makes implicit reference to CBR in Article 26 where it is stated " Support participation and inclusion in the community and all aspects of society, are voluntary, and are available to persons with disabilities as close as possible to their own communities, including in rural areas." Article 19 of the Convention refers to " the equal right of all persons with disabilities to live in the community, with choices equal to others" .

These developments also reflect the changes in CBR from medical orientated, often single-sector approach, to a comprehensive, rights-based approach based on community development principles. The positive benefits of CBR are documented in evaluation studies from different countries

Along with the need for consolidation, there has been much debate about the future directions for CBR. The future of CBR is in working in line with the principles of the UN Convention. The future of CBR is also about building strong partnerships, especially with disabled persons' organisations (DPOs), families of persons with disabilities and with governments. As stated in the 2004 joint position paper of ILO, UNESCO and WHO, " CBR is implemented through the combined efforts of people with disabilities themselves, their families, organisations and communities, and the relevant governmental and non-governmental health, education, vocational, social and other services" . This implies networking and building of partnerships at different levels and across different sectors. CBR cannot exist in isolation and needs to build partnerships with different key stakeholders to achieve the goals of inclusion and empowerment of persons with disabilities.

Barriers exist in building these partnerships, especially between DPOs and CBR. There appears to be a gap between big DPOs and CBR because of lack of awareness about each other's strengths. Many DPOs see CBR as a service delivery mechanism in rural areas, while DPOs themselves are seen as urban based and elitist, with little knowledge of the realities faced by people with disabilities living in poverty in many developing countries. Some DPOs at national or international levels are not fully aware of the current understanding of CBR as an inclusive, rights based approach. It is important for DPOs to work with CBR programmes, especially those working in rural and remote areas, to share resources and information. CBR programmes can build capacity of persons with disabilities and their families through self help groups, and link them with the bigger DPOs at different levels; while DPOs can act as the bridge between governments and self help groups promoted by CBR programmes from the grassroots levels.

DPOS can play a role in sensitising governments, including local government authorities, of the importance of the UN Convention, of CBR and of DPOs; DPOs should advocate and work with governments to promote CBR and other programmes for persons with disabilities in their countries through appropriate policies and legislation.

Because of its multi-dimensional nature, CBR needs partnerships between a variety of stakeholders who can contribute to and benefit from it. Dogmatic, 'either/or' approaches are not relevant anymore. Instead of territorialism, all stakeholders need to understand the importance of working together to capitalise on each other's strengths and work in a complementary manner to fulfil the goals and principles of CBR.

Dr. Maya Thomas

Editor
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