Cover Image
close this bookSustainable Development and Persons with Disabilities: The Process of Self-Empowerment (ADF, 1995, 117 p.)
close this folderSection I: Understanding and perception
close this folderChapter 4: Community-based rehabilitation
View the document(introduction...)
View the documentPractices in relation to the PWDs
View the documentWhat is CBR?
View the documentCase studies
View the documentA general assessment of CBR: Possibilities and limitations
View the documentAction guidelines

Case studies

Mawotto Lake Transport Project, Uganda: A Case Study of CRV

Mawotto is a little peninsular village on Lake Victoria in Uganda in the sub-county of Ntenjeru in the District of Mukono. In its sunny wave-swept shores live a community of about 70 households, including 12 families of the blind. Most of these families were trained in agriculture at the Salama Agriculture Training Centre. The Centre was started in 1956 by Sir Cruther Mackenzie, himself blind, from New Zealand. Mawotto was selected as a settlement area for the blind by the Uganda National Association for the Blind (UNAB).

Terri and her husband Stanlake are both totally blind. Terri is from Teso District in the north of the country, and Stanlake is from Mukono District in Buganda, and they met at the Salama Training Centre. Terri lost sight at the age of one year because of measles ("I am lucky," she says, "I've no idea what sighted means.") Stanlake lost his sight when he was eighteen. They have four children, all sighted and now grown up. Musoke, 20, deals with the fishing project of the village; Robina is 16, Michael 14, Omonding 10, and they are all at school Terri herself teaches at the local school where all the children are sighted. "How do you do it?" I asked in wonder. "There is no problem, somebody helps me to write on the blackboard, "she laughed. Stanlake works on the farm. "We use the same tools as the sighted," he replied in answer to my question, "only the technique is different. Our rows of maize and potatoes and beans are even more straight and neater than those of the sighted, "he teased. Stanlake is also the Chairperson of the Mawotto Branch of UNAB.

With the help of UNAB, the blind families started the Mawotto Lake Transport Project. The idea was to ferry people across from the village over to the other side of the Lake into Kampala. A feasibility study was done. Some members got training in project management. They applied for funds from the African Development Foundation (ADF) to purchase boats and other equipment, and to their pleasant surprise they were successful.

Two more projects were added: a piggery ("the second best in the District of Mukono"), and farming. Now they have food to eat and the surplus is sold to generate cash.

"We have the same problems as those who are sighted," the chairperson explained, "Some people from Kampala are cutting down our trees for commercial purposes. The hungry monkeys are now descending to feed on our maize. Also, on account of some pest in the soil our bananas (matoke) are not growing well. We have to solve these problems together." "Yes," another member added- "Charles is a member of the RC 1. Whenever we have a problem, we mobilise the RC (Resistance Council) system."

When asked "How are you linked with the rest of the community?" one of the members of the Mawotto Branch Committee of UNAB replied: "Two of our members are teachers; in fact, Byekwaso, our Project coordinator is the chairperson of the Parent-Teacher Association of the school." A female member of the Committee added that a blind person is the chairperson of the Women's wing in the village.

Here is an example of a CRV type of CBR fully in operation. The blind live and work within the community, sharing its pains and pleasures. They are fully integrated into the life of the community, doing their own things quite independently and yet in partnership with the rest of the community.

Bwaise, Uganda: A Case
Study of NDC, OMT and CIP

In the outskirts of Kampala not far from the citadel of learning (Makerere) and the country's national hospital (Mulago) lies a peri-urban sprawl of crowded tenements of people trying to make a living on the edge of history. Not that the owners of the shops that line the main street with open drainage are poor. They are rich, but they don't live in Bwaise (for that is the name of this shanty town), they only come there to collect their profits. Behind the shops, in ramshackle dwellings erected hazardously on a swampy terrain live the real dwellers of Bwaise. They are frequently water flooded. Rubbish heaps abound. Mosquitoes thrive. Inevitably, there is malaria which affect especially children with cerebral malaria that results in brain damage. These must be among the poorest people in the world. And amongst them those with disabilities (of all kinds) must survive through sheer force of will.

Simon Lutaya writing with his toes. (Photo by COMBRA)

They are facilitated by an organization called COMBRA - Community Based Rehabilitation Alliance - founded by two determined health workers, a dedicated former nurse and a physiotherapist of Mulago Hospital working initially as volunteers in their own time. COMBRA has now become a recognised institution for training in the CBR approach to disability. They now offer course "modules" in CBR management and management of specific disabilities. The courses are based on a combination of theory (12 weeks) and field work (4 weeks).

Each trainee is allocated two families who have a member with disability in Bwaise. The trainees come once a week to visit the families of the disabled persons, and they practise hands-on assessment, counselling and therapy. Since their founding in 1990, COMBRA has trained 50 community workers in CBR. They have lost 10 to some donor-funded organisation that paid them enticing salaries to do research on AIDS. Of the others, five work as CBR volunteers with COMBRA.

Simon Lutaya of Bwaise

At Bwaise itself, COMBRA has set up a clinic to attend to people with disabilities. At the time of the author's visit there, the clinic had 78 PWDs and 160 elderly people on its register. Next to the clinic is a Day Centre -Tuesdays for the elderly, and Thursdays for the PWDs. Whilst some are engaged in handicraft at the day Centre, others come to talk, to dance and to make music. A physiotherapist comes once a week to give therapy and to monitor progress. Friday is the day of referrals, when some of the more serious cases are taken, by bus or by taxi, to the nearby Mulago hospital.

To witness one of their "successes" they took the author to visit Simon Lutaya. He was born prematurely and later developed cerebral palsy. For nine years he was not even brought outside the house. He is now 14, goes to school, and writes his name using his toes. He now has a wheel-chair, and although, with his father dead and his mother sick, the future does not look assured, Simon exudes a spirit of amazing self-confidence.

Among COMBRA's successes are the following:

· Early identification of problems
· The outreach clinic
· The referral system
· A change in the attitude of the community
· Building a sense of hope and confidence among the PWDs
· Integration of disabled children in mainstream schools
· Promoting sustainable income generating activities