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

Practices in relation to the PWDs

Past and present practices in relation to the people with disabilities fall into six distinct categories:

Isolation: The worst practice is isolation. It is a form of rejection. It is the denial of the very humanity of the person, especially so of people with disabilities arising from illnesses such as leprosy, epilepsy and mental impairment.

Get it from the horse's mouth

Is it true that you want to know?
Do you want to know about disability?
Do you want to know about disabled people?
What do you really want to know?
Why not get it from the horse's mouth?

I am physically disabled I need love,
I am blind I need shelter,
I am mentally disabled I need patience,
I am deaf I need attention,
Now you are getting it from the horse's mouth

It is not enough I have more.
I need education for my future.
I need to be employed for my future.
I need to be encouraged by you.
Now you are getting it from the horse's mouth

No, I am not through
I need to be next to you not far.

Girlie Hlanze, Swaziland

Practices in Relation to PWDs



Institutional Welfare

Educational Approach

Medical Approach


Overprotection: This, too, is a form of denial of the personality and capability of the person with disability. You can suffocate a person with excess love and sympathy. The effort to secure independence from family is sometimes almost like fighting a liberation struggle.

Institutional welfare: The more liberal forms of isolation take the form of special treatment of the PWDs in rehabilitation centres. These include both state institutions as well as those set up by (NGOs) especially the churches. This involves considering PWDs as objects of charity an welfare. Although justified in special situations, its more generalised application to all the disabled persons constitutes a gross insensitivity to those amongst them who, with support, can look after themselves.

Educational approach: Traditionally, governments and (NGOs) have tended to reinforce the isolation of children with disabilities by establishing special and separate educational institutions, such as schools for the deaf and the blind. Unless absolutely necessary, e.g., for purposes of learning braille, the aim should be integration within the mainstream.

The medical or professional approach: Once again a case can be made for certain kinds of disabilities that can be helped or alleviated through short periods of physiotherapy, psychotherapy or communication therapy. But a wholesale application of the "medicalist" approach to disability is both harsh and harmful to the PWDs. It isolates the clinical aspect of disability from the whole physical, psychic and spiritual being of the PWDs, and must be avoided at all cost.

Community Based Rehabilitation (CBR): As distinct from the above practices, CBR encourages communities to accept PWDs as integral members of society.

This chapter focuses on CBR, not in order to exalt its virtues in comparison to other approaches but in order to look at it critically in the light of some practical experiences. The other objective of the chapter is to examine what facilitative (or enabling) role the community can play in relation to the disabled people, in the light of our discussion on the "enabling environment" in the previous chapter.