Community Based Rehabilitation

A Documentation of much(prenominal) a complete finish feces non be completed with bulge out the stand by of numerous sources and masses passim the long rugged path of success. I too realized this event and so, I inject this opportwholey to thank them entirely. Personally this documentation has attend toed me to rootise k promptlyledge and skills to understand people with disabilities and their struggle for survival. in that respectfore it indeed gave me a huge opport reconstructing blocky to larn the confederacy base replenishment political schedule ( cosmic microwave sustainground radiation) of Womens arm inwardness (WDC) understand the run they bind to the people with disabilities. This documentation would non strike been possible if non for the genero layy of number of soulfulness who pass their cartridge holder with me. In stir upicular, I wish to ack promptlyledge Ms. Pearl Stephen, fail Director, Womens Development sharpen (WDC) who prompted me to undertake this study and for giving me the guidance and maintenance. I similarly wish to ack promptlyledge the support and informative guidance of Ms.Dammika Podiemanike, Coordinator, WDC cosmic microwave cover songground radiation computer political platformmeme. I ex decennaryd my thank you to all the rounds of cosmic microwave background relieve oneself by mental act for back up me byout this study by providing and facilitating to obtain necessary in arrangement Finally, I must mention hither that all those who back up me in servinging of ferment me to document provoke done so with an expectation of a sure-fire documentation. Such an expectation has been my source of inspiration and encouragement. I express my solemn thanks to all of them albeit that I may non be fitting to present their names.Having completed the documentation, it is my hope that it turn in serve as a source of learning for those who atomic number 18 interested on the subject o f commwholey of interests ground renewal e peculiar(a)ly who argon interested on investigate on such(prenominal)(prenominal) a subject, for donors to perish an sense as to how their resources ar serving the humanity and al virtually of all as a ruminative material for WDC management and rung for appreciating their own educate as wholesome-nigh as for further sweetening of their course of study. It is my wish that this documentation will lead to a enceinteer extent light to further enhance safeguarding the undecomposeds of the alter someones.Ranjan S. K. Nellimale Documenter August 2007 confine 01. INTRODUCTION01 02. BACKGROUND DETAILS01 The take aside of WDC is to WDC Vision Mission WDC Tar throw collection major(ip) atomic number 18as of work District Level Womens Fora attached to WDC Womens meshing 03. OBJECTIVES OF THE certification11 04. METHODOLOGY OF DOCUMENTATION11 05. THE METHODOLOGY USED FOR DOCUMENTATING11 06. COMMUNITY BASED refilling 11 What is cosmic microwave background? 07. WOMENS evolution CENTER AND COMMUNITY BASED REHABILITATION13 Vision of cosmic background radiation affectionate whole of WDC Objectives Activities A. Kandy companionship ground replacement Centre15 Day c atomic number 18 marrow Counselling name and address and actors line Therapy a. diction categorise b. Speech Therapy c. Language Therapy Physi an separate(prenominal)apy unit of measurement Special Education class Behaviour Modification B. Vocational upbringing Centre (VTC) Ampitiya23 C. Manikhinna federation found re administration heart26 D. Matale Community Based refilling Centre28 E. Teldeniya Community Based reclamation Centre29 F. Haragama Community Based replacement Centre31 G. Madolkale Community Based replacement Centre33 H. Ulapane Community Based refilling Centre34 I.Pothgoda Community Based replacement Centre36 J. Galpihilla Community Based renewal Centre38 K. Community Blind Rehabilitation architectural plan39 08. REMARKS 42 Intervention Rehabilitation Prevention 09. CONCEPT OF COMMUNITY reproduction44 10. report LEARNING FROM THE DOCUMENTATION PROCESS 45 1. tinct on the discap equal to(p)d souls 2. Impact on Family living 3. glide slope to go and facilities 4. Impact on neighborly relations 5. Capametropolis structure of Vocational preparational activity 6. Access to loans for those with vocational Training 7. Community Aw arness 8. Self Help Group formation 9.P atomic number 18ntal Capacity Building 10. Advocacy 11. RECOMMENDATIONS49 12. ANNEXURES54 COMMUNITY BASED REHABILITATION PROGRAMME OF WOMENS phylogeny CENTRE 01. INTRODUCTION The concept of Community Based Rehabilitation create by mental act is that dis abled people should adopt the right to a severe life and fulfil their of necessity. The cooperate they need should be engagey(prenominal) to them at a low cost. It should offer to them and their family a steering that suits their usual style of living, whether in a village, a town or a city. They should induce rearing worry ein truthbody else and on that point should not be each disparity.They should be able to take up the customary activities similar jobs and achieveing their own living without discrimination and exploitation. They should be able to take in full part in all the activities of their village, or town or city or at heart their families. The idea of cosmic microwave background radiation is that, even if people tally precise slowly, or assimilate difficultys incuring or hearing or, rise it hard to move nearly, they should notwithstanding be respected as existence men and women, girls and boys. Nobody should look down on them, nor be hard-boiled any less than a normal person just beca engagement they subscribe to a dis talent. 2. BACKGROUND Womens Development Centre (WDC) is an transcription established in 1987 and registered as an NGO in 1989. The aim of WDC is to Help Women enhance their affair in Socio-Economic life and abet them take up leaders exercises in various capacities. WDC Vision To have a society where women and barbarianren be actively involved, having equal hazard to, get at to, and restraint oer resources and working in the bea of advocacy and policy to their own checkment and of their families.Mission Facilitate and raise an environment to strengthen the position of women and children in society by addressing womens and childrens issues and community ken, thereby reducing victimization improving opportunities for attractive in in vex generation activities and cognisance to mend their make its with adjoind k in a flashledge and through group support and activities. WDC Target Group WDCs work involves women from disadvantaged communities but alike expands to include youth and children from all ethnic and sacred groups predominantly in bucolic aras.Major areas of work Crisis Intervention Community establish Re habilitation Ne twainrk with seven district fora and new(prenominal) compositions with similar aim and objectives. Community festering (health, community organizing, community sensation and working with conditions) Pre- cultivates and daylight give care heart and souls Resource displace Legal aid/ charge programme Disaster give-and-take District Level Womens Fora attached to WDC Womens Network 03. OBJECTIVES OF THE DOCUMENTATION To explain the concept of the Community Based Rehabilitation (cosmic background radiation) program as implemented by WDC. How far has the cosmic background radiation program brought commanding doctor to communities where it is implemented. To bring out where wobbles are taked for a more hard-hitting cosmic background radiation programme. 04. METHODOLOGY OF DOCUMENTATION The Community Based Rehabilitation program (cosmic background radiation) has been documented by using Descriptive method. The documenter used generally interviews a nd observations to gather entropy. 05. THE METHODOLOGY USED FOR DOCUMENTING The initial discussion with Mrs.Pearl Stephen as the author and initiator of the program as headspring as some opposite bring up individuals overhauled in developing the interviews and observation guide. The information gathered were summarized and analyzed to permit major leanings and conclusions. 06. COMMUNITY BASED REHABILITATION Community Based Rehabilitation approach is said to be suitable for developing countries with limited resources to win wider coverage of operate. The importance of cosmic background radiation approach is the transfer of minimum rehabilitation skills and responsibility to minimally trained family members and other volunteers in the community.The last ten-spot saw the growth of community based rehabilitation in umteen developing countries, along with changes and adjustments in the concepts and practices think to this world e exceptionally in countries a give care Sri L anka. What is CBR? Mrs. Pearl Stephen, Founder Director of WDC who initiated CBR, perceives that any hindrance to modify people is liberation for those who are the care takers of the most marginalised persons. In fact, it is the rationale for a womens organisation such as WDC to be involved in the issues of the alter.According to her, it is a programme that safeguard the rights of the disabled persons ever-changing their surroundings, including enabling the family and the community in this task. It is a sustainable work out that utilises as much local anesthetic anaesthetic resources and techniques as possible to intervene, rehabilitate and minimise natural event of disabilities. A strategy within community development for the rehabilitation, equalization of opportunities and social integration of all people with disabilities (UN definition) CBR is a strategy for enhancing the whole tone of life of disabled people by improving service delivery, by providing more equitable pp ortunities and by promoting and protecting their human rights (E. Helander ). 07. WOMENS DEVELOPMENT CENTER AND COMMUNITY BASED REHABILITATION The Womens Development Centre (WDC) is a local Non-Governgenial Organization (NGO) based in Kandy. The aim of the institution is to promote womens status in society by mental synthesis condenser, developing partnerships and supporting cognisance on health, legal rights, gender leadership development crisis intervention and skills preparedness, networking and action- research on womens issues.The WDC began by course a community health horticulture program in collaboration with local medical officers of health. As the health volunteers gained the trust of many another(prenominal) families and communities in which they were working, they detected of many disabled children who had suck ind little, if, any, dish up. Many were hidden away in shame and fear, around even corpo very imprisoned in there billets. The fires were in desper ate need of help and support in coping with the stresses and embarrassingies of caring for these children.Following requests from the parents, it was agreed that a rehabilitation programme be started in November 1990, with the children already interpreting the WDC midsection in Kandy on two mornings in a week. Some of original health volunteers be do the rehabilitation workers and their teatimech was extended by attendance at paediatric, psychiatric and ENT clinics as well as short courses at a particular(a) initiate for hearing impaired children. The programme was well attended and rapidly true, with immature sharpens opening in local villages in response to community requests.thither are 10 community based rehabilitation (CBR) focus ons run by WDC in number of places such as, Ulapane, Manikhinna, Pothgoda, Madolkalele, theldeniya, Galphila, Matale, Ampitiya, Haragama and in Kandy. The village centralises are in tabernacles halls and other community premises. They funct ion with the co-operation / support of the local community. These different heart and souls work with hospitals, trains, incision of nurture, the divisional secretariats and the various service departments within these secretariats. The programme taps a peck of local resources from parents, divisional secretariats, department of social function and so onMost of these departments have a drawing card of respect for the flavour of service rendered by WDC unit and the rapport they are able to develop with the departments and the clients alike. Vision of CBR Unit of WDC Create an environment where the person with limited needs trance applaud equal rights and maximum benefits within the family and society. Objective Minimize conditions that lead to disabilities rehabilitate persons with disabilities temporary hookup world in community Advocate on issues related to disabilities of persons Activities Maintain community based rehabilitation digests Maintain special(a) ed ucation units Maintain vocational culture centres for person with special needs down community education programs Develop and support networks with and for people with disabilities Mainstream of work and issues of person with disabilities A. Kandy Community Based Rehabilitation Centre The Kandy CBR group currently functions as a separate unit close to the WDC main office. A total of 48 cater are spread over ten CBR centres. thither are 10 Staff members rendering their support to the Kandy centre.In general, all of the centres whether in the urban areas like Kandy or other centres in rural areas, there are a raw material set of go and activities rendered. Therefore, this document would not try to elaborate all these activities in all the centres but try to indicate some of the unique features of the different programmes. The centre in Kandy, in the sense, buttocks be seen as the hub and coordinating place. It is the cooking and orientation centre as well as legal opinio n centre of many disabilities where a man-sized number of clients from different split of the island access their initials services and referrals.The babies and children be the CBR programmes have wide range of disabilities like hearing and visual impaired, language dis consecrates, acquire difficulties, and behaviour problems, physical and mental disorders. There is lack of space for special education schools and units so the children will move from the centres to get special education. However, some of the children are having multiple difficulties which perk up such placement more difficult. There is a system to swear out the very young and other children with difficulties.Those who start to seek the services of the WDC Kandy centre trace from various parts of the island through different sources, such as through referrals from hospitals, doctors, hospital clinics, special education department, organizations and some times any one who has heard of this CBR program from a f riend or relatives likewise bring their children or send off. Some of the services rendered by CBR Kandy centre is counselling, vernacular and language therapy, day care centre, visual program, physio-therapy and special education class. Day Care Centre The Day Care Centre of the WDC CBR unit entertains children requiring Day care facilities for both WDC supply and others. The singularity of this centre is the top executive to integrate both normal and children with special needs. short there are 18 children (both girls and boys) in the pre school age in this day care centre. Two of the children are from crisis intervention centre of WDC at Haragama which serves women and young girls who have impudenced violence. Shabana is a 6 days archaic child having a physical disability in her hand, arly she got physiotherapy treatment from the centre and now she receives normal pre school education. Counselling Counselling is an a interactive process conjoining the counselee who nee d assistance and the counsellor who is trained and ameliorate to give this assistance, the counsellor laughingstock initiate and maintain the interactive process if he/she communicates feelings of spontaneity and warmth tolerance, respect and sincerity. One of the main work done by CBR Kandy unit is providing counselling to the parents and the children with disabilities.When the parents approach the organization for help, the first thing that the CBR counsellors do is a detailed assessment regarding the problems of child and the related causes by using formats developed by them. In this process the CBR counsellors try to help the parents to clarify the problem and the way how to build the helping process. In the end of this process the counsellors will direct the parents towards next step and to the type of service required. Speech and Language Therapy The main objective of this unit is to help children in improving Speech and Language skills. a.Speech class Speech class are str ikeed for children who are having row difficulties such as stammering, autistic, Down syndrome etc. it is an individual effort with each child. These children are referred by schools and hospitals. The children go through initial assessment while being in the speech class. Those who require intense rehabilitation are determine and provided with further intervention. After the initial assessments and corrective measurers, these children are referred to special education units and followed up on a monthly assessment basis. Some children are in addition followed up at homes during home visits . Speech Therapy Those who are back up through speech therapy are those with more intense turn toing disabilities such as those who have difficulties with voice and exeursing the tongue. Sometimes such intervention require around one year of treatment process. c. Language Therapy Language therapy is often for the children who have extreme difficulties in enunciateing such as desensitise children. Such children are assessed and intervened to alter sounds, sign language etc. The deaf children in particular are referred to the deaf school in Dodanwala to alter them to continue their school career.Even while the children enter the deaf school, they are s bowl followed up until they reach a aim of approach. physical therapy unit The physiotherapy unit plays a vital role to improve the functional ability of children with physical disabilities. This unit performs a number of important services such as assessment of the level of functional ability of the children, perform rehabilitative exercise on children, education and trains parents on exercises, sustainmental and health requirements of children to improve these condition.The other function of the unit is also to improve impound and affordable rehabilitative devices that could also be turned out in the rural homes. Special Education class The children who fill out to the special education unit are referred by schools or these who are on the verge of dropping out of schools callable to skill difficulties. These are children who require special anxiety or not able to cope in class agency situations. Special education class provide the children with l authorizeing difficulties to over come their problem and to develop the knowledge.It provides the children to understand the weakness they have and to get the help of the faculty of the centre. The staff have developed a correct race with the children and it helps most savants to improve. Behaviour Modification This unit is one place where children who have extreme behaviour difficulties such as those who are hyperactive or are not able to concentrate. They are received to a special unit where they are provided with guidance and unique activities to help them sit in a place, improve concentration, improve working together, learn patience, etc.After these, children learn to control themselves, they are moved to other section for re habilitative exercises. B. Vocational Training Centre (VTC) Ampitiya The aim of the vocational centre of CBR is to assist children with special abilities to develop their skills to enhance their dignity by helping them to explore and learn nearly their inherent skills and develop them further to enable prolific and more autarkical living. The children have special talents. After their education, if they are not supported to enhance, they may be lost while they enter the lager society.This is oddly true for the children with mental and physical disability. They usually do not get sufficient assistance from government. To cope up with this situation and to reduce the problems they face, in 1999 WDC started the Vocational Training Centre (VTC) within the CBR. In the beginning VTC started with 24 students and give them discipline in carpet make, envelopes, piece bags and in carpentry. The Ampitiya centre belongs to the (government) department of social serves and WDC was reques ted to run this centre.As WDC maintain very good rapport with government departments but lacks required resources, this request was considered timely and opportune. This centre has terzetto units for residential care, vocational training and school for special education. Mostly, the vocational trainings are for those children who pass out from various rehabilitation centres and have no other future prospects. At present, there are around 20 children both females and male children learning various skills, not only at the Ampitiya centre but also in other community level rehabilitation centres.The type of vocational training are Carpentry, Eakle b manner production, compact disk production, Cement flower pots making, Handloom, Sewing/rug making, Fabric/Pottery paint, inclose making, Paper bag making, Home gardening, Greeting cards, Stocki-net flower making and mend work. It must be mentioned that it is not easy to train children with disabilities with certain physical mental disa bilities. The teachers require patience and concentration all the time particularly when they are training to use various tools. season some products can be promoted to competitive markets, this is not always possible.Some children take a very long time to learn the skills but some perhaps cannot go beyond making rugs. Some of the trainees who train the children themselves have been trained by the VTC As part of network building the teachers of VTC also visit Digana rehabilitation hospital for spinal injuries to give vocational training for patients. This training while it goes as part of rehabilitative exercises, also provides a good training to start own employment in their theatres. Further staff of Digana hospital says that those training also have tremendous psychosocial jolt on the patients.There are many programmes conducted in collaboration with the government organizations and most of the time the VTC receive invitations /requests to participate in their programmes. Spe cially sports events and other competitions. It really help student to appreciate their own capacities. In the year of 2007, 3 students were selected from Amptiya VTC to represent Sri Lanka for paratrooper Olympics in china. C. Manikhinna Community Based Rehabilitation Centre Manikhinna centre was started in the year of 1992. During the 14 year period, it has provided a variety of services to the community. presently the centre is located at the Ganadevi kovila, old temple and provides the services to the children with disability as well as to the community. The main aim of the centre is to use the functional resource in the community and use them for the development of socially wound people. Mainly this centre carries out the process to rehabilitate mentally and physically challenged children. Counselling, speech therapy, mentally retarded (MR) class, vocational training and Physiotherapy are the major activities carried out in this centreThe centre maintains good human relatio nship with the temple and the local politicians and the benefit of good rapport improves their service to the community. Manikhinna Community Based Rehabilitation centre has provided many services to the community. The program has enabled the community to build some houses and toilets among the needy families. Parents too get self-importance employment training in order to doctor the family financially stable. The centre strongly weigh to make a better environment for the child. Making the family self diligent help the child considerably in the rehabilitation process.The training to parents on self employment further helps to integrate the children with disabilities within family and community. So many changes have also occurred in the community sine the CBR program began in this community. Among them is the awareness of disabilities that has taken place among the community and community under stand this charitable of children require special anxiety and care. When the Manikh inna centre initially started, the staff visited many communities. In the process they also determine villages classed as Low caste, and those working with devils. hese village were normally omit by other villages, and government officers never visited them nor did the temple accept their alms. However, when the CBR staff started to visit them, inviting the priests and government officers to the CBR centre, the situation started gradually changing. Sudeep is a 16 year old boy having learning difficulties. According to the doctors he is a mentally retarded child. He come from a piteous family and his suffer left him and the family. CBR helped his stick to build a house because they do not have comme il faut shelter. Currently this child is attending Speech and Language Therapy classes in the CBR centre.It is elicit to note that this child manages to read and write to some extent. When the documenter asked Sudeep whether he could visit his newly built house he was overjoyed. Wi th outmost interest Sudeep help the documenter to visit his house and get information virtually his village. The development that has taken place in this child is important to the society as well as for the childs own future. D. Matale Community Based Rehabilitation Centre Matale Community Based Rehabilitation Centre was started in the year 2000 and currently it is situated at Hunukate Alokaramya Temple.The service rendered by the staff of this centre are recognized by the people and they give their fullest support to the CBR program. There are 75 children currently getting the services from this centre. It carries out the rehabilitation activities for mentally and physically challenged children. It provides Counselling, speech therapy, MR class, self employment training and Physiotherapy. Due to ignorance and lack of awareness most of the community people face many problem. The CBR centre has taken steps to conduct awareness programs to the community, such as the orthopedic camp c onducted by the Centre for Handicap organization.It is a good exemplar of how the CBR unite coordinate with other organizations to improve the services for the people. Anther awareness program is on nutrition. It is an important program for the community as most of the parents and children do not have proper nutrition. Good nutrition has been identified as one of the most important aspects to minimize disability. Documenter got the probability to speak with the midwife of the community and learned how the CBR program benefited the lives of people. According to her foregoing there was no awareness among the people about the disabilities and they totally neglected those people with disabilities. scarce when the CBR staff started to work with the people they became aware about the problem and sought the help of the CBR centre. She also mentioned that the staff are able to build a good rapport with people and provide a lot of support to those who approach them. Amila Kumara is a stu dent doing his come on level (A/L) this year. His mother is working abroad and his father is dead. At the time he approached the CBR program, he was totally neglected by his family members payable to his physical disability. He has hindrance to straits.Due to this difficulty he did not attend the A/L classes. But with the support of the CBR centre he has improved a lot and now he can walk by himself. He got so much of motivation from the CBR staff and support that encouraged him to do his A/L. He will sit for the examination this year. He is so happy about the CBR program and he says that because of this program his life has changed. E. Teldeniya Community Based Rehabilitation centre Teldeniya centre was started in the year of 2004. Currently the centre is lacated in the Teldeniya original school.With the limited space this centre is functioning well and provids much services to the community. In this centre Counselling, speech therapy, MR class, self employment training and Ph ysiotherapy programs are operational for the community. As the centre is located within the school premises, it has developed a strong relationship with the school programs and work closely with the school to provide better services. This centre also conducts awareness programmes and organize womens groups. This centre too provides training on self employment. Tailoring class seem popular.There is a teacher employ by Government manipulation this class for the parents of these children. In this centre staff have been able to create a good environment with government officials as well as other top level officials in order to provide better service to the community. Documenter got an hazard to speak with the school principal and learn how the CBR program fulfils the needs of the community. According to him, prior to the program there were no support to the children with mental and physical disabilities, they where totally neglected within the schools as well as in the community.T he CBR programme provided these children with disabilities an opportunity to come out of their difficult situation. According to the principal earlier there was no one to help the children with leaning and behavioural difficulties in their education in the school. Teachers were disinterested in such children as they where more interested to help the able children. After the rehabilitation programme was started, we are now able to send these children to this centre and now I am happy to see the advancement of these children collectible to the help they got form this program. Some of the children we sent to this centre have come back and are now studying with normal children, It is a joy nice to see how they have change. Deshika Kolabaga is a 6 year old child having much difficulty in her behaviour pattern. Since 3 years she is attending the CBR centre and gets speech therapy and special education support. According to her mother Deshika underwent so much of difficulty with in the f amily due to her ways of behaviour. alone her family members neglected and reject her. But since she started to attend the CBR program she has remarkably improved.She has been able to get over most of her behaviour problems, she is now able to do her work normally and manage to win every one hearts in the family. The family members now understand that she has to get special care and caution from the family. Deshekas mother is so happy about the staff of the organization and says that it is due to their care and support that her child has improved and she is thankful for them. F. Haragama Community Based Rehabilitation centre Haragama centre was started in the year of 2004, since then there have been so much of changes in the community because of the CBR program.It has given lot of services to the community for the up abductment of children with disabilities. Currently the centre is located close to the WDC Crisis centre. deal other CBR centres this centre too caries out the dutie s of rehabilitating mentally and physically challenged children. It provides Counselling, speech therapy, MR classes, self employment training and Physiotherapy. Most of the parents of children who come to the centre said that prior to bringing their children to the centre, they faced many difficulties due to lack of awareness on how to handle the children.But with the CBR programme, life has sprain much easier. It has also facilitated looking at the problems as a community. The parents of these children are very poor and therefore the CBR programme also help the mothers through skills training on basket making etc. It is evaluate that afterwards this training the mothers will engage themselves in self employment. The documenter had the opportunity to speak with a group of basket-making women in the centre, they were so happy and willingly came forward to explain how and what kind of service they get from WDC as an organization.The mothers explained that prior to coming to the CB R program, they faced much hardships and their children experience many difficulties in learning, behavioural problems, etc due to the disabilities. However the mothers are very happy about the improvement that they see in their children. They also feel relieved due to this improvement. The mothers also appreciate the training they received to work with their children to participate in the rehabilitation process of their children. G. Madolkale Community Based Rehabilitation centre This centre was started in the year 2000.The program in particular supports the disabled children in the grove sector. Currently the centre is located close to Paramsehwara Tamil College Madolkale, and looks after around 24children. Because this centre is located in close proximity to plantation sector, most of the children come from families working in plantation sector. Serving the plantation itself is a unique experience for the WDC/CBR unit, as there are very few programs implemented to serve the e state sector. Compared to all other projects of WDC/CBR unit, the parents of most children have a very low level of literacy.In general, though it is a community living close to each other, it is not a close community that supports one another. Since both parents go to work, the children with disabilities and often the mothers who are burdened with many functions face a lot of difficulties. initially the staff also found it difficult to located children. It was also difficult to make parents understand why it is important to pay special attention to children with disabilities. Gradually the programme has taken root in the community. The parents, teachers and children are now able to understand its importance.Because the school community and children appreciate the program, the organization enjoys good reputation. There are 24 children who attend speech class, speech therapy, MR class, and self employment training. Other than this, 2 families receive the help of WDC. One parent was helped to cement the floor of their house while another received tea plants to initiate an income generation activity. As the staff identified the problems of low nutrition being low, they also conducted training and education session on nutritionThe documenter had the opportunity to speak with some of children who were engaged in sewing handkerchiefs. These were children with learning difficulties as well as physical disabilities. According to them they are happy now because they get the opportunity to learn some useful things for their future and these children really feel more secure due to the CBR program. There are other skills training activities such as bag making, making envelopes and candles, etc. H. Ulapane Community Based Rehabilitation centre Ulapane centre was started in 1995.During the 17 year period it has given many services to the community to help through many development activities. Currently the centre is located in at the Ulapane Maha Vidyalaya and providing the services to the children through the special education unit. In my view, compared to other centres, Ulapane is a difficult terrain to work due to hilly slopes. The area that the staff are required to cover is wide. Children are brought to this centre from very far places. The staff also require to travel far to make home visits.There are also many physically disabled children that the parents are unable(p) to bring to the centre on a routine basis. Therefore, the staff are required to make much effort to visit all of them despite transportation difficulties in the area. Also the resources are very limited the like other centres it principally carries out the process of rehabilitation of mentally and physically challenge children. It gives Counselling, speech therapy, MR class, vocational training and Physiotherapy. This centre has built a good reputation among the government officers and the social welfare organizations. According to the school Principal, the CBR program has c reated so much of awareness about disabilities in the community that it has execute easy to identify disabilities among the children. Initially people did not have an understanding what this center was doing for children with disabilities but, with time, they have gained understanding and started to help the school in ways they could. He said It is a privilege, as a Principal, for me to take part in this program. Listening to the Principal it was sack to me that he is satisfied with the CBR program and appreciates the work they are doing.The change in awareness and the quality of life of children are unusual. The staff of the Ulapane unit also indicated that apart from the services they render to the children, the mothers of the children also have become members of a womens forum. Through this forum, the mothers get training and support to develop income-generation towards economical empowerment. Ashma is a girl having learning difficulties. She has been dropped out from two sch ools and never given enough support and guidance for her education. She has been totally neglected from the school and it created some confusion and difficulties for her.When her father started to take her in to the CBR program she started present improvement in her education and her father is vary happy about her development. According to her father she is getting proper care and support for her education due to which she is motivated and shows interest in studies. The Father said now he could understand why she was not able to study well in the schools, that it was due to the lack of capabilities of the schools teachers to understand slow learning. When such children started attending school and fall into the wrong and incapable hands of teachers, the school careers of children are ruined.Such children then become isolated and ashamed. They are branded as those who cannot study, quite an than saying that they were in the hands of incapable teachers. From the above case-study, it is clear that the kind of service provided to the community become more important and indeed it create lot of awareness about disabilities and what kind of services are available for them. I. Pothgoda Community Based Rehabilitation Centre This centre is located at Pothgoda Rajasinha Vidyalaya as a special unit. This unit started to work in the community since 2002.The importance of this unit is mainly to concentrate to bring behavioural changes and help slow learning children to get proper support through education. The special ferocity of this unite is to provide special education to the children who are having learning difficulties due to M/R. It should be noted that not only children with MR face difficulties of being misunderstood, the parents too face difficulties and are saddened by the fact that they are not able to understand their children. The parents of these children are engaged in cultivation as their main occupation and most of the parents are poorly literate.This ha s an impact on the development of the children. Children with disabilities normally get isolated from the families and get neglected. They may not receive proper care and support. Therefore, the services of the CBR unit become important to develop the sensitivity of the family towards children with disabilities, so that proper attention could be paid to children. From the perspective of the children, when children are not understood and proper attention paid by the school, most children end up as drop outs from schools. Therefore, such units are playing an important role to lift the education level of children.They are able to make improvements and get back to the normal education after they gain improvement. The staff also divided that in families where there are children with disabilities, the families also have many conflicts that make the life of children extremely difficult. The staff understanding this situation, also provides counselling. According to the principal, this uni t has had major impact on the community and to lift the standard of education of the children with disabilities. Recently, the unit also conducted an awareness program to the school teachers on depression. other awareness programme for the community was on nutrition.Such programmes have provided many benefits for the children and their families. He noted with satisfaction that some children have been able to get back their normal class after improvement. J. Galpihilla Community Based Rehabilitation centre Galpihilla Centre has been started 1998 and currently located at the Galpihilla primary school. The function of this unit is to provide special education to the children who have been identified to have learning disabilities. Most of the children in the unit have multiple difficulties and shown improvement with CBR intervention. The children who come to this centre come from the nearby community.As has been explained, in relation to other centres, it needs to be reiterated the hap less situation of the children with disabilities where there is no understanding how to handle and care for such children. According to the principal most families in the community are poor and this poverty situation directly affects children with disabilities. With the intervention of the CBR on the lives of children to develop their level of independence, it has helped to free the time of the parents which adds to their awareness and their co-operation in this regard. Rumasha Abeyanaike was born in 1990 with physical disabilities.Her father is a labourer. His moolah are not enough to meet the needs of family. In 1992 she came to the special unit for treatment. Because of her physical disabilities she was not able to move freely. With the help and support of the centre she gained control over her limbs and posture. With the exercises, by the CBR staff and at home by her parents, within about 4 years she was able to sit. When she was able to control her limbs, she was trained to us e thread frames to develop skills. She excelled in both education and in making lace work. Over the years she also learned to work with out help.All these achievements have do her family very happy. K. Community visual Rehabilitation program Community visual Rehabilitation program is one among the important activities carried out under CBR program. It mainly concentrates on the blind or the people who have difficulties in their vision. Currently this program functions as a separate unit under CBR program. This program was introduced in 2001. Because of a good network system that WDC has developed they received an invitation from an organization based in the south of Sri Lanka to send three volunteers for a training program on blindness.After this training program was over, the 3 volunteers trained other staff in the WDC. A study that was subsequently conducted around Kandy, identified 128 persons with vision difficulties. Identification of such a large number of persons from all a ges with vision difficulties is an eye opener to the divisional secretariat as the general perception was that blindness is not a problem in Kandy. The aim of this program is to deviate from a purely clinical precedent of intervention.Therefore, the intervention contains a package of service of screening, awareness on prevention of blindness or to make those with vision difficulties independent and productive counselling to those affected and their family members reducing poverty through involvement in income generation activities etc. While all 128 persons were referred for medical support, initially the programme identified 4 people for holistic care intervention. The expansion of the programme firstly concentrated in the Gangawata Korale divisional secretariat for 23 persons and afterwards to Pathahewaheta and then to Harispathuwa divisions.In 2004, the number of clients in this programme increased to 43 persons. The clients feel that since they participate in the rehabilitatio n programme, they received more respect from the family members, earn as well as, save money, and it has contributed to improve the quality of their lives As part of the programme, the blind people underwent special training and counselling programme like how to do their day-to-day activities how to use the white cane and the ways of earn a living. Because of this program, some are engaged in small seale quite a little such as selling cloths, tea, etc, while some make paper bags, lamp wicks, joss sticks, etc.Kusumawati is a middle-aged lady with vision problem. When the Community visual Rehabilitation program reached her, she was living with her sister and was dependent on her. Once she got sufficiently rehabilitated, she started working in a near by joss sticks factory. However she did not receive sufficient salary. The CBR staff helped her to manufacture joss sticks in her house. She was able to earn and save money from her business, and build her own house and started to live on her own. Now she cooks her own meals and does her day to day activities by herself. From the financial ssistance she gets from the government and with the income generated from her small business, she is able to live happily. Above case study a good employment of how a Community Blind Rehabilitation program could help the lives of needy people. There are many social welfare organizations in and round Kandy district but the only organization giving support to blind people to improve mobility and to start self employment is Womens Development Centre (WDC). Joss Sticks making Goat rearing 08. REMARKS There is sufficient evidence that the CBR programme makes a big battle in the lives of the children with disabilities and their families.Most of the children in the CBR program come from the poorer sector which itself is a big a hindrance for development, as children tend to lack the basic needs that are vitally important. The programme has proven its viability to improve the quality of life. Intervention It is evident from many responses, that the CBR staff are experienced and skilled than most others like teachers to make good assessments of client to identify the condition of the children with disabilities. , whether they come from schools or community. They are able to be holistic in their assessments.They are also better able to build good rapport and win government agency of the children, their families and others such as school teachers, principals etc. Their level of professionalism and also the way they receive other support in the assessment enables them to develop more effective rehabilitation plan that is holistic. Rehabilitation Rehabilitation is the most important process in CBR programme. It creates opportunity for the children with difficulties to receive right intervention and rehabilitation to overcome their problems with the help of the staff in the CBR program.There is a wide range of difficulties which are visible, with children like the ph ysical disability, learning difficulties, behaviour problems, blind, profound deafness, hydrocephalous, down syndrome, multiple disabilities, speech problem, autistic and mental retardation. In the CBR programme they carry out activities to help the children to over come their problems and through this process they are rehabilitated. The activities such as Counselling, speech therapy, MR class, vocational training, special education class, awareness programs and Physiotherapy.It is remarkable to see how the staffs of the CBR program work closely with the children as well as with the parents to fulfil the task to improve the status of children and create an environment for the personal development and make rehabilitation process efficient. What is also interesting is that of available facility for those who get sufficiently rehabilitated, to follow vocational training to make their future independent and skilled, with life-long impact. The vocational training helps them to be employe d or to start their own business with the support of their family members. Prevention although it not possible to totally exterminate people becoming disabled, the CBR program carries out a number of programs to minimize people becoming disabled. While some of them are to raise awareness among the communities such as on intake of proper nutrition, discouraging marriages among blood relations, other are to eradicate poverty, poverty being the root cause for many evils including disablement. Further, the programme also helps marginalized community to learn various services such as health, come to receive rubella or other referrals or even making education more easily available to marginalized. 9. CONCEPT OF COMMUNITY DEVELOPMENT The CBR approach is a holistic process spanning from individual development, keep through to community. The process can be summarized in the following mood emanating fram the individual Speaking about a person with disabilities, he/she is a person with man y problems/ difficulties from within and outside. So the CBR process renders services to solve the disabilities within and this makes the rehabilitation process more effective. When the mind of the person becomes stable and strong, it leads to the improvement of the body conditions.It then leads to develop the spirituality of a person. It is clear when a person develops ones spirituality it leads to the development of his/her social status. All these processes together with other support, then leads to economic improvement. When the rehabilitation of a person is achieved, the process does not end there. It then leads to have appointed impact on the community. Rehabilitation process should develop like a cuticle and it will be a continuous process. 10. KEY LEARNING FROM THE DOCUMENTATION PROCESSAs a documenter, in this section, I wish to present my overall impressions regarding the CBR programme. In overall performance, there are many positive termination and impacts as a result o f the CBR programme. 1. Impact on the disabled persons There is an observable change in the quality of life of the children and adults with disabilities as they get enrolled with the programme. They improve in mobility, coordinating limbs, enable continuation of education, improve in communication etc. ost of all, it enhances their dignity transforming them from a dependent, helpless person to an a independent person with abilities. Therefore, the process promotes individuals to become more independent and productive. Engagement on vocational training is a good example of improvement towards economic independence. For creating this impact, the skills of the staff, their commission, rehabilitation techniques and in particular the social counselling process, have found to be important. 2. Impact on Family living at bottom the family, the disabled persons have gained more recognition and acceptance.There is also marked improvement in the sensitivity of family members towards them and therefore, the disabled persons have been able to get appropriate support from the family members. Instead of the dependant persons that were there before, with CBR intervention, the disabled persons are able to contribute to the house-hold chores or in some instances, contribute economically. By this contributions they make, some of the family members who were earlier trapped in to care giving roles, have been freed to become productive by themselves.It is notable in particular, how the mothers have been made free to a large extent. However, it must also be mentioned here that during the initial period of rehabilitation, the work of the mothers also increase tremendously. This extra commitment on their part has not been without rich reward. 3. Access to services and facilities There is more recognition for the disabled person within the various services such as health, education, resource provision by the divisional secretariats etc.It also has improved the system of providing the referral the much needed attention from the service sector. 4. Impact on social relations In general, there is increased awareness among communities regarding disability situations and therefore the need for community members to work together. While there is more recognition for the disabled persons within the family, especially parents have come together to discuss common issues regarding the disabled children. In the CBR centres, there is a marked contribution by parents together as a community to make the programme a success.Particularly in one community, the programme also helped to unify a socially isolated community. 5. Prevention of Disabilities Promoting the use of Rubella vaccine, improved nutrition through awareness and training on use of low-cost and natural foods, awareness on compatible marriages etc are seen as specific contribution of the programme. Apart from the above, the following are also identified as areas where there needs to be further improvement 6. Capacit y Building of Vocational Training The present vocational training that are done especially in the rural centres, has a greater otential for improvement in terms of concept and technical inputs. Developing of substance of teachers handling this work is important. Further, they also require knowledge and skills to make think to markets and the demands. 7. Access to loans for those with vocational Training At present, WDC CBR programme provides a lump sum amount to those graduating from the VT. What is not clear is the after-support to family as a unit such as access to loans and follow-up in the development of the income generating activity to a viable enterprise. 8.Community Awareness It is observed that the greater emphasis of the CBR is on the families directly involved in the programme. This the documenter sees as a limitation. Involvement of the community as a whole will create a bigger and sustainable impact. 9. Self Help Group formation Strong Self-Help groups in the communit ies where the CBR programme is implemented is considered an asset as it is not only able to provide stability, but also provide economic support involving both the family members of CBR and other members in the community.One other ability of a self help group is also its ability to tap resources within and outside community. 10. Parental Capacity Building It is discover that for any emergency or a need, look up to the staff of CBR to provide leadership. Through community capacity building programme, while it can reduce the work load of staff, it could also provide sustainability to the programme. Therefore, it is plummy that within the programme, capacity building of staff be treated as a specific focus to achieve the set objectives of the programme. 1. Advocacy There are many issues for which advocacy are required. It is unclear on WDC role on policy advocacy. Two specific areas that has paused a challenge are the effort to do away with the special education units and the other i s the poor knowledge of parents and the clients on the rights for services and facilities for the disabled persons. 12. Linking community Development and Networking The plug into between the efforts of the CBR with the community development and Networking which are key perpetration of WDC dose not surface clearly.Therefore, this coherence of the programme requires further enhancement as finally, goal achievement in communities are common. 11. RECOMMENDATIONS The current CBR programme has a big impact on the lives of the disabled people and make the way for the social development. It is indeed a programme with lot of potential. However there are still areas with the CBR program, the staff can look, further father develop and improve the standard of the community based rehabilitation process. 01) Developing the capacity of the staff in Assessing local needs and resource identificationsThere is no one model of rehabilitation service that will suit all circumstances based on local sit uation. What is needed is a needs-based model for the different circumstances. Some early programmes of CBR were not successful because they did not undertake any research on the perception/needs of the target population, or even considered the availability of local resources. Although there has been improvement in this, the resource identification can be further harnessed. Additionally, there is much room for research based model development.While WDC staffs do understand the cultural barriers and surrounding, the disabled persons, their families and even how such children are hidden due to many different reasons, it is certainly beneficial to conduct in depth study to explore information in order to develop local models of intervention in a more veracious way. In this servies, information within the family systems, factors that influence marginalization of disabled person from participating in social activities, career aspiration by the disabled person, etc. should receive critic ally sharp focus. 02) Disability related Policies, and Programs and disturbance MeasuresIt is apparent that the WDC staff contributes much in the intervention, prevention and rehabilitation process of the disabled and over the years there is both qualitative and numerical improvement in their work. This does not mean that there is no room for further improvement. The documenter observes that the knowledge of WDC staff in relation to the policies, programmes and preventive measurers that is available in the larger environment, including in the international arena would help in raising the awareness of communication and in motivating the communities more to wards advocacy.3) Building up resource centre for CBR It is important to maintain an information centre or resource centre to provide the latest information about community based rehabilitation programs in different parts of the world and its new findings for the development to build or improve the capacity of the staff. There is also a need to upgrade the knowledge of CBR staff in terms of latest development in the field of disability through personal enhancement as well as having access to IT information. Family Help Line It is observed that the families of the disabled children supported by WDC mostly live in remote areas with minimum access to root such as transportation etc. Such families can also be identified as multi-deficit families with poverty, voieance, marginalization etc. Due to withdrawnness of location of the families, for staff to visit with limited resources is seen as difficult. A family help line is therefore suggested to be developed when such families could reach at time of needs especially for legal, counselling and referral support, as such a system to access will support as an initial measure.This may be a neighbour ceiling womens group, knowledge of professionals help with close proximity etc. This may work as a quick and effective linkage between community and the CBR program. Support Groups It is observed that most of the families of the disabled children are accessing the CBR centres for every need related to their family needs, thes creating an a opportunity to make the families totally dependaed on CBR program. So in the long run this is not good to reach the CBR objectives. Therefore, formation of Support groups in their communities is strongly recommended.Support groups enable individuals with disabilities and their families to exchange ideas where both positive and negative views can be expressed. It also provides a capacity within the community in emergency situations which support groups can provide. ? Hope ? entropy ? Friendship ? Sharing ? Problem-solving ? Personal growth ? Advocacy 04) Forming neighbour hood Groups It can consist of 10 to 20 members in neighbouring villages near to CBR centres having homogeneity in social status, sex, income, occupation, disabilities. It is the basic organization of poor and the marginalized create and wor king at the grassroots level.It is a group that can take responsibilities in the issues where CBR program is functioning. It will be a great chance to build up a strong community relationship to reach disabled people in all communities. 05) Awareness programs Although CBR programme conducts many awareness programs to the community, it is important to conduct awareness programs to increase the knowledge and to build a strong support system. It provides a butt where the CBR programs can be implemented more effectively with the help of the community. The awareness program can cover the flowing anticipated outcomes local anaesthetic leaders have increase awareness and their capacity to make changes in their community and the values to organise local people to take positive steps to support the rehabilitation of disabled people. Local people have to increased their sensitivity towards the disabilities and their vulnerabilities. Local people have greater confidence in their own ability to make appropriate changes as they can to promote community based support to the people with disabilities. Effective and current community organization and action on safe-guards rights of the disabled. Improved local services and facilities in education, health, sanitation which have a big impact on the disabled children. To develop educated and confident people to take and speak of the issues related to self help measures. 06) Training of the CBR staffs Efficient training of the newly appointed staff in the CBR program in order to have a positive out come in whole program. It is suggested that the staff get training in every aspects of rehabilitation care in the main Kandy centre, by being able to pass off certain amount of time in every unit till they are exposed and skilled.