What Is Community Based Rehabilitation (CBR)?

CBR is an approach to provide health and education in isolated rural areas in developing countries, to better reach adults and children who have disabilities who are unable to travel to cities or larger communities.

During the last twenty to thirty years of CBR activities sponsored by various international organizations including the World Health Organization and the United Nations, we have seen CBR evolve and operate many different ways relating to local cultures and types of conditions (environment degradation or prone to civil conflicts).

In the 1960s, public health and medical professionals operated on the medical model of treatment towards persons with disabilities. The rehabilitation model was new at the time, to assist those with disabilities and others rendered disabled from illness or injuries. Instead of institutions in cities where roads and/or other transport routes can be inaccessible, the village or township would have a facility with local patients and locally trained staff.

In the 1980s the social model - disabled people running the CBR themselves as staff, peers, trainers, and educators - slowly emerged. A paper in the United Kingdom exhibited some reluctance of able-bodied (non disabled) persons to receive disability awareness, sensitivity, and inclusions in the workplace as well as in society from disabled professionals. To this day, it is relatively common for an able-bodied person to train in the workplaces and receive better reception from able-bodied workers than disabled persons would.

A little more of history of the original form of CBR itself: Einar Helander, who is called the "father of CBR" who worked with the WHO and other professionals in rehabilitation recognized that there were many people with disabilities in developing countries who were not getting the health services they required. The rehabilitation professionals transferred the equipment and knowledge from the developed countries to underdeveloped and developing countries.

In 1970s there was recognition and understanding by professionals and WHO that the transfer did not work due to different cultural values and lack of available accommodations.

Over the years, WHO, UN, and other international organizations such as Handicap International implemented policy and provided funding to interested countries to establish facilities and encourage local people to be hired and trained in not only health and rehabilitation, but also to operate the facility and liaise with the larger communities or cities for resources and information purposes.

The CBR approach was also intended to be a place for persons with disabilities to interact and share their experiences. The community benefits from the experiences of persons with disabilities and vice versa. However, many CBRs continue to be health oriented and services are provided by able bodied staff and volunteers.