Abstract

Rehabilitation in the Philippines has in the past been based on the Western model, with an emphasis on hospital departments located in the major cities. This approach is inappropriate for the majority of disabled people in the Republic as 70% of the population live in rural areas. A community-based programme was devised using local volunteers who had simple training. These volunteers can identify and support disabled people in their own villages, avoiding long journeys and expensive institutional care.

PIP:

Because 70% of the disabled people in the Philippines live in rural areas, a trial of community-based rehabilitation services (CBRS) according to the WHO model was conducted in Bacolod City, the capital of Negros Occidental province, in 1981. Until this time, rehabilitation could only be done in major centers with highly trained specialists and special equipment. Design of rehabilitation for people in rural areas is complicated by the fact that disabled people are isolated from each other and have varying types of disabilities; funds, personnel and equipment are scarce; Western-based methods may not apply in rural areas; rural people cannot afford to pay for rehabilitation; and they often have secondary disabilities due to poverty. Community-based services are provided by community workers, families, and volunteers, intermediate level medical personnel, and specialists after referral. This pilot project employed local supervisors trained in early detection and simple techniques. Local supervisors were chosen based on residence, willingness to work with the disabled, and English literacy. An expert committee followed the WHO manual, "Training the Disables in the Community," to train the local supervisors in the areas of mobility, speech, hearing, seeing, and learning. A local project committee was formed to implement and monitor the project. The local supervisors were trained at the Department of Rehabilitation Medicine of the Philippine General Hospital by a multi-disciplinary team. They were given specially prepared forms to document their work and they had at least 3 clients each. The major obstacles of the program were a lack of referral services, the low priority given to the project by some local agencies, difficulty gaining cooperation of some families, and a misunderstanding of the role of the local supervisors. Nevertheless, the CBRS is a cost-effective means of delivering rehabilitation services to rural areas.