Termination of CBR training in South Africa by Bongi Zuma
MESSAGE: CBR training ensures continuing support and quality of skilled CBR workers, which leads to the improvement of the lives of people with disabilities (PWDs).
Summary
With this article I would like to highlight the negative impact of termination of CBR training so that HPCSA will reverse the decision to terminate CBR training. Among these is the intensified lack of rehabilitation service in the community due to the shortage of CBR workers. Termination of CBR will result in poor rehabilitation services in the community, increased poverty amongst PWDs, and poor involvement of PWDs in the community development activities. Ongoing support for trained CBR workers will also come to an end.
Therefore it is recommended that the HPCSA (Occupational Therapy Board) should think about doing an appropriate consultation with the Department of health (disability and rehabilitation component), PWDs and community leaders about the termination of CBR training. Besides evaluating the impact of CBR training, national and provincial government should ensure that policies that are rehabilitation and disability related are implemented, monitored and evaluated
Termination of CBR training in South Africa
BACKGROUND OF CBR TRAINING IN SOUTH AFRICA:
CBR is defined as a strategy for rehabilitation, equalisation of opportunities and the social inclusion of people with disabilities within the community.
CBR is implemented through the combined efforts of people with disabilities themselves, their families, organisations and communities, relevant governmental and non-governmental, health, education, social and other services. (WHO, ILO, UNESCO 2004)
CBR Education and Training for Empowerment (CREATE) is a Non-Governmental Organisation (NGO) involved in the training and education of CBR workers through out southern Africa. Currently CREATE offers a two-year certificate course in CBR and other training activities related to rehabilitation and disability modules. The training of CREATE is accredited by Health Profession Council of South Africa (HPCSA) through the Occupational Therapy Board.
CBR Training Institutions in South Africa include:
• CREATE (KwaZulu Natal) has successfully trained 43 CBR workers (13 are still on training).
• Institute of Urban Primary Health Care (IUPHC) in Gauteng province trained 75 CBR workers
• Community Based Rehabilitation Research and Education. (CORRE) in Limpopo Province trained 120 CBR workers
The majority of the CBR workers are working for the Department of Health while others work for the NGOs. They work towards the equalisation of opportunities and integration of PWDs. More than 10 CBR workers from the southern African countries have received training in South African training institutions these are 4 in Botswana, 5 in Namibia and 4 in Swaziland.
However, CREATE is the only remaining organisation which provides CBR training while others are no longer operating due to financial reasons.
On completion of training, CBR workers perform the following duties:
 Identifying PWDs in the community
Provision of assistive devices
Promotion of health
Raising disability awareness in the community, government departments and private sectors.
Facilitating the formation and sustainability of the support groups and income generating projects
Facilitating collaboration between government departments and PWDs
Facilitating integration of PWDs in the community development actives
Facilitating rolling out of the inclusive education pilot project
Promoting disability rights
Organising celebration of the International Day for the Disabled People (IDDP) together with other stakeholders
Promoting the CBR concept
The availability of skilled CBR workers contributes to the change in the negative attitudes of the community towards PWDs. CBR workers also encourage participation of PWDs in communities (rural, peri-urban and urban areas). This is done through working with different community leaders and structures to involve PWDs actively in the community development activities. A PWD witnessed this in KZN after a traditional wedding. “After I had a stroke I was not allowed to perform the traditional dance because the disability was perceived as a disgrace”. To help address such issues the CBR worker and community leaders ran a workshop on disability awareness showing the importance of inclusion of PWDs within the community.
The above discussion draws attention to the fact that CBR training contributes to the lives of PWDs. Unfortunately HPCSA resolved to terminate CBR training into training people who will be more profession specific and will be called Occupational Therapy Technicians (OTT). This article seeks to highlight the negative impact of terminating CBR training in South Africa.
Termination of CBR training will result in the decline of the availability of skilled CBR workers and lack of sustainability in the provision of rehabilitation services in the community. This will lead to:
• increased poverty amongst PWDS
• poor participation of PWDs in the community development activities
• decline of the capacity building amongst PWDS
• increased discrimination of PWDs in schools and community
• end of the ongoing support for trained CBR workers, PWDs and their families
• poor relationship between stakeholders such as PWDs, universities, government, NGOs and community Based Organisation (CBO)
• reduction of in-service training of supervisors of the CBR workers
• uncertainty among different government and NGOs about where to send people for CBR training
Personal Experience
I grew up in the farm called KwaMxhoza in KwaZulu Natal and had a disability due to polio. There was a school, which was burnt down. Currently there is no school, mobile clinic, church, no clean water and bad roads. Growing up in this area was very difficult and even worse for a woman with a disability. Nevertheless I managed to do my Matric (the final stage in education system before one goes to university) and later through CBR project I got funds to do CBR training and was able to work with other PWDs.
As the assistant trainer and fieldworker at CREATE I have been to areas worse than my home area. I saw the positive impact that the skilled CBR workers brought to the lives of PWDs. For example in my culture there are lots of beliefs and myths about disability. But once a CBR worker explains to the PWD and family about the cause of the disability both traditionally and medically the following things happen:
• peace amongst the family members and neighbours
• more information about the disability
• acceptance of disability by a PWDs and the family members
• participation in therapy.
Conclusion
Given my personal experience as a PWD seeing the role of CBR workers and positive impact of the CBR training, I appeal to the HPCSA to reverse the decision of terminating CBR training. PWDs in rural areas are benefiting a lot from the CBR programme, more so different departments from different provinces still need to send people to do CBR training including the Department of Health.
I recommend that HPCSA should consult with the Department of health (disability and rehabilitation component), people with disabilities and community leaders about the termination of CBR training and also evaluate the impact of CBR training. Additionally, national and provincial government should ensure that policies that are rehabilitation and disability related e.g. (Integrated National Disability Strategy) are implemented, monitored and evaluated. National government, disability sector, NGOs and CBOs should also critically look at the future of CBR in South Africa and give proposals on where CBR should be amongst government departments. |
