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Training on
Community Based Rehabilitation (WHO module)
A report by
the Community Based Rehabilitation Project
Department of P.M.R & The Low Cost Effective Care
Unit, CMC, Vellore
A 10-day
training on CBR was conducted in November 2004 at CMC, Vellore by the
departments of PMR & LCECU. A group of 9 health professionals who were
selected by the WHO, from different parts of India participated in this
training programme. The objectives of the training
were outlined such that the participants could at the end of the training be
able to plan and carry out CBR programme in their
community. (Ref. Annexure.1)
Participatory learning approach was emphasised
to enable the trainees to have adequate exposure to the community and the
lives of persons with disability (PWD) Formal lectures and classroom teaching were kept to the minimum essential. (Ref. Annexure. 2)
In addition to using professional resource persons from CMC, the course was
designed so that the Local Supervisors (Volunteers from the community),
persons with disability (PWD) as well as their family members were given an
important role in the training programme through
sharing their expertise and experience. The professional resource persons
included faculty from various disciplines like Community Health, Physical
Medicine & Rehabilitation, Ophthalmology, Psychiatry, Physiotherapy,
Occupational Therapy and Social Work.
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The training was structured so
that the field visit was followed immediately by the guided discussion with
the expert resource person pertaining to that particular aspect of
disability. For example, in the session on training for ‘difficulty in
learning and strange behaviour’, the participants
visited persons with psychiatric disability in the community, which was
followed by an interactive discussion led by the Psychiatrist.
In addition to the regular field visits, formal visits
were made to other institutions working for PWD like “School for the
blind”, “School for the deaf and blind children”, “Day care centre for
children with mental retardation”. Home visits were also organized to
enable the trainees to interact with persons with severe disabilities
following spinal cord injury, polio and amputation.
As in the WHO CBR programme,
we continued to use the problem solving and educational model during the
implementation of this training programme. The following paragraphs highlight some
of the salient features of the training programme.
Bringing the
group together
The trainees came from
different parts of India
with varied linguistic and cultural backgrounds. It was essential to bring
the group (participants and resource persons) together, so that the
training could be effectively streamlined, communication could be open and
without apprehension or reservation. During the welcome session, there were
games and activities so that the participants soon became a vibrant group
at ease with each other. Each participant volunteered to act as a Rapporteur for the discussions that followed the field
visits. The course plan and training objectives were explained to the
participants.
Pre and post training assessment
To evaluate the
effectiveness of the training programme, a pre training assessment and a post training assessment were conducted. (Annexure.3)
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Ice Breaking Game
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Rapporteur
Presentation
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Pre-test-What lies ahead?
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Field visits
 The
Local Supervisors acted as the facilitators for the field visits. The field
visits were organized in such a manner that the participants could get
adequate exposure and interaction pertaining to one area of disability during
each visit.
They were given opportunity to interact with persons with
a wide range of disabling conditions and different age groups. Trainees were
given guidelines for field visit, as some of the participants did not have previous experience of working with the community. (Annexure.4)
Home Visits
Home visits to six rehabilitated persons with severe
disability from varied background were organized. All participants expressed
that the home visit was an ‘eye opening’ experience for them and in fact they
all felt motivated. The discussions following home visit helped them
to analyse both contributing as well as hindering
factors for PWD in the community.
Visit to Institutions/tertiary centres
The participants were taken to various institutions
working for and with persons with disability. The following institutions were
visited:
 School for the blind, Vellore
School for the deaf and blind children, Vellore
Vocational rehabilitation centre run by the
Mary Verghese Trust, Vellore
Nesam – a day care
centre run by the parents of children with cerebral palsy and developmental
problems at Arcot.
As
part of the CBR training, the role of tertiary care centres
was explained. The participants were taken to various units of Physical
Medicine and Rehabilitation department and Ophthalmology department of Christian Medical
College, Vellore.
Content of the training
In addition to the WHO
module on different disabling conditions, sessions were conducted to explain
the concept of CBR, planning and implementation of the CBR, prevention of
disability, impact of disability and the relevance of social and vocational
rehabilitation and special problems encountered by the elderly in the
community. Sessions on Legal rights and government schemes for disabled
persons generated active discussion among the participants.
Methodology of the training
Problem solving and
participatory learning approaches were used for the training. The sessions
were planned in such a manner that they were exposed to the real world of PWD
and this was guided by the Local Supervisors (Volunteers from the community).
The participants were
oriented before each field visit and assigned to observe and collect
information from the PWD in the community with relation to each disabling
condition. They were encouraged to interact with PWD and evaluate the
existing solutions. Experts from each area of disability were made available
to help the group to focus on different possible options of intervention and
the relevance in the community. Role-play, experiencing disability,
one-to-one discussion, and group discussion were different methods used to
make the learning experiential.
Resource materials provided on completion of training
The following resource
materials were given to all the participants:
WHO manual on ‘Training in the community for
persons with disability’
Government schemes for PWD (Central government
and States relevant to the participants)
Legal rights of PWD (The Persons with
Disability Act 1995)
Follow-up
Towards the end of the
training, the participants were eager to take on the challenge of CBR in
their own hometown linking to institutions where they work or NGOs. We have
offered the team our support and readiness to share our expertise whenever
necessary.
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