Los surrealistas y el objeto después de Duchamp

Lightfoot (2004:456) finds that childhood disability is mostly caused by malnutrition of the mother and the child, injuries before and after birth, exposure to toxic substances and infectious diseases. This then can result in physical and other disabilities. In developing countries they find prevention and rehabilitation to be the best strategies to assist the disabled persons and their families. Rehabilitation helps to prevent, treat and improve physical disability conditions.

Lundgren-Lindquist and Nordholm (1993:83) defined rehabilitation as described by the World Health Organisation as “…all measures aimed at reducing the impact of disability and handicapping conditions, and at enabling the disabled and the handicapped to achieve social integration.” The Disability World Report of 2003, defined community based rehabilitation as “…a strategy within general community development for rehabilitation, equalization of opportunities and social inclusion of all children and adults with disabilities.”

CBR is an approach introduced by the WHO to provide rehabilitation services. According to the WHO Action Plan of 2006-2011 on Disability and Rehabilitation, CBR is practiced in 90 countries around the world and is involved in an inclusive multi-sectoral strategy of providing health care, education and livelihood opportunities. CBR is used by both developed and developing countries. Lundgren- Lindquist and Nordholm (1993:83) continue by explaining that community based rehabilitation involves measures taken at the community level to use and build on the resources of the community, including the impaired, disabled and handicapped themselves, their families and the community as a whole.

CBR aims at assisting people with permanent physical conditions by making the disabled people independent through the provision of special assistance that builds on their abilities.

4.2.2

The need for community based rehabilitation

According to the WHO Action Plan of 2006-2011 on Disability and Rehabilitation, CBR is planned to help people living in rural areas and those in urban areas who cannot reach urban rehabilitation institutions and services. Lundgren-Lindquist and Nordholm (1993) indicated that CBR involves community based resources, works with the community and disability organisations and has successful referral and supporting arrangements for disabled persons.

CBR can be illustrated from the perspective of the social model. Lightfoot (2004) purported that CBR is a three-tiered model because it rehabilitates on three levels: mobilization of community resources, recruiting and training community workers and training family members in basic rehabilitation services, providing the necessary information and offering them support. Most services of the CBR model should be provided to the disabled people at their homes. The services are not expensive, because community resources are natural and simple. Also, because the rehabilitation is community based, it is able to deal with cultural issues that concern the disabled people and their families. CBR entails educating the community and families of the disabled people and forming support groups to strengthen them. Then, according to the WHO, the services are supervised by professional workers like physiotherapists who work with the community. According to Lightfoot (2004) and Trevillion (2007), social workers are ideal for the work as the profession is better

suited to working according to the social model than the medical model. Social workers have experience in working with the community and coordinating services. CBR is supported by most countries and their governments are including it in their plans. For example, many countries like Zimbabwe, China and Botswana have participated in piloting CBR and have accepted the CBR model. According to the MENA Report of 2005, in order to promote and support the development of the CBR strategy in African countries, the CBR Africa Network (CAN) was established in 2002 with its secretariat in Kampala, Uganda. The Mission of CAN is: “To promote access to appropriate information on disability and development for all people in Africa.” Its objectives and activities include: collecting and collating information about disability services from all African countries; facilitating the development of a record keeping and writing skills culture for the purpose of documenting community initiatives and good practice, as well as facilitating the capacity of CBR workers to communicate their experiences between themselves and with other practitioners.

According to Lightfoot (2004:457), in contrast with community based rehabilitation, institutions based rehabilitation follows the medical model. The institutions based rehabilitation is professionally based and uses complicated tools to provide services. It also needs big budgets to provide these services and facilities. Furthermore, the institutions based rehabilitation is mostly located in urban areas rather than in rural areas, thereby isolating their the services they provide. Even though the method is helpful, it has added complications for developing countries, including Botswana, such as budgets, distance and facilities, as discussed above.

Since communities are different, CBR is applied differently in different countries. CBR is therefore a flexible, dynamic and adaptable strategy that aims to increase respect for the rights of individuals with disabilities, improve access to services and increased opportunities for all children, youth and adults with disabilities in the community. CBR is a multi-sectoral strategy that promotes and facilitates access to health services, education, vocational skills training, income generation activities and participation in all aspects of community life.

The above explanation shows the importance of the real idea behind the rehabilitation and why it should be community based. It involves both the disabled and the family by helping them to have a comfortable and better quality of life in the

community. The CBR is needed to assist with the work with physically disabled people.

4.3

PHYSICAL DISABILITY AND COMMUNITY BASED