Introduction
Involving community leaders in community based rehabilitation programmes is essential for sustainability, effective implementation and expansion of programmes. A lot of CBR programmes have been initiated in different countries in the last decade. The sustainability, effective implementation and expansion of these programmes have been a challenge due to the lack of involvement of community leaders in these programmes. Evidence from other CBR programmes suggests that involving community leaders from the beginning will ensure sustainability and expansion.


Background
My experience in CBR programmes is drawn from three programmes that I have been involved in. The first one was Chihota project in a rural area in Zimbabwe. I initiated the programme after I had been approached by the local Member of Parliament. The project started well after two years the community had to manage the project. Eighteen months later we did an evaluation. The outcome was that the community had lost interest in the project. They did not know enough to carry on. The Income Generating Activities were not successful.

This could have been due to the fact that we did not involve the community leaders in the beginning and they did not have enough information on disability. They looked at this project as ours and not theirs. The two other programmes were in S. Africa. I supported two with the initial funding. For the first two years the programmes were fine. The mid term review was done in the third year. Again the same pattern as in Chihota was observed. Community leaders were not interested. They did not have enough knowledge about disability to carry on. This article identifies four strategies that can be implemented to involve community

1. Involvement of community leaders in planning, implementing and evaluation
Programme initiators can start by making a list of the community leaders they are going to invite. The list of community leaders in any given area may include the following: - chiefs, headmen, religious leaders, teachers, nurses, businessmen, local councillors, and traditional healers and youth groups. These community leaders can be contacted directly or through schools, clinics and business centres. Youth groups can be used to distribute letters of invitation. Posters with full details of the venue, time, date of the meeting can be placed at strategic points in that community.

It is important to check that there are not any other events happening on the same day to avoid clashes. If it is in a rural area it will be better to hold this first meeting during the dry season when people are not busy in their farms.

On the day of the meeting start by defining what a CBR programme is and explain how this programme will address disability issues in that community .You can give a definition from the 2002 ILO-UNESCO-WHO position paper. Which is ‘CBR is a strategy within general community for rehabilitation, equalisation of opportunities and social inclusion of children and adults with disabilities'. You may need to translate the definition into the local language for it to be understood. Circle the key words in this definition targeting this group. Key words could be ‘a strategy within general community development’. Facilitate community leaders to reflect on people with disabilities. Divide participants into small manageable groups and ask them to brainstorm on the following questions:-
1. Why should we as community leaders be involved in this CBR programme?
2. Is it important for us to improve the quality of life for people with disabilities?

Let the group work for thirty minutes, move round the groups as they are working, supporting them where necessary. After this, the group can come back for feedback. Record their answers on a flip chart. Their answers may include the following:
• People with disabilities in our community are full members of the community
• People with disabilities have a right to basic needs, education, health, food, water
• It is our role to improve the quality of life for people with disabilities because they are our brothers, sisters, children and spouses
• We need more information on different disabilities
• We have so many blind people in our community
• People with disabilities ,when gainfully employed ,will contribute to income tax
• We need to form a committee to co-ordinate this CBR programme
• We need to form parent’s support groups
• We need the rest of the community to know about this CBR Programme

If some of the above points have been left out, discuss those points with the group and add to the list. To conclude this session, community leaders and programme initiators have to come up with an action plan on:
• What needs to be done?
• Who should do it?
• When should it be done?
• What resources are needed?
• Where do we get these resources?

2. Providing information on common disabilities
Working with the committee which has been elected in the last session, programme initiators can give information on common disabilities. They can give handouts on polio, cerebral palsy, hearing impairment, learning disabilities and the blind. Pick the disability which is more common in that community and write a detailed handout. Facilitate the elected committee to understand its roles and responsibilities through brainstorming on what the roles are .You can suggest the use of drama as this will clarify their roles. You need to prepare a good scenario which will bring out their roles.

3.Supporting newly formed groups and the existing DPOs
The programme initiators can strengthen new support groups and the existing DPOs in that community by:
• Facilitating training sessions for mothers groups on income generating projects.
• Mothers can brainstorm on what kind of projects they can start.
• Where will they get the seed money and where are they going to sell their finished products.
• Daily living skills, training mothers and siblings using the WHO manual.
• Sessions on developing project proposals for funding.
• Sessions on how to lobby with the government to ensure that acts and laws in that country on disability are being implemented.

4. Creating awareness for all stakeholders
The whole community need to know about this new CBR programme and how they can refer their children and adults with disabilities. Project initiators government ministries and community leaders can conduct awareness meetings. They can use posters showing disabled people who have made it in life: disabled people who are now businessmen, lawyers, doctors, or managers of companies. These will serve as role models. People with disabilities get more motivated by listening to their colleagues who have been successful in life.

Ask the local police to talk about the numbers of people who have been disabled due to accidents in that community .Police can explain how accidents can be avoided by giving an example on drinking and driving. Leaving unguarded fires near where children are playing is dangerous.

Conduct sessions for mothers on good health, expectant mothers to visit pre and post natal clinics. Encourage balanced diet and plenty of fruits during pregnancy .Inform mothers on the importance of going to the clinic in time as delayed labour can cause brain damage. Talk about nurses attitudes towards pregnant women. Use a role play on how some nurses behave towards women with disabilities as they attend pre and post natal clinics. Peer discussions encourage community leaders to talk about disability issues as they go cattle dipping and fetching water from a common borehole.

Conclusion
Using the four strategies discussed above, will enhance the sustainability of a CBR programme. The end result will be an enabled community who have knowledge skills and effectively implementing the CBR programme