community based rehabilitation : the korean model dr. il-yung lee ri korea, national secretary ri...

Community Based Community Based Rehabilitation Rehabilitation

: The Korean Model : The Korean Model

Dr. Il-Yung Lee RI Korea, National Secretary

RI Vice President, Asia Pacific Region

ContentsContents1. Evolution of CBR

2. Development of CBR in Korea

3. CBR services & delivery

4. CBR Stakeholders

5. Main service areas

6. CBR Matrix

7. Case Study

8. Challenges

1. Evolution of CBR1. Evolution of CBRFirst suggested by RI (RI Conference, 1969)

- To improve rehabilitation services in developing

countries

Initiated by the WHO (1978)

- To improve access to rehabilitation services for persons

with disabilities in low and middle income countries, by

making optimum use of local resources

Repositioned (2003)

- As a strategy within general community development, in

partnership with ILO, UNESCO and WHO

Overall objectives (WHO 2010)

- To promote CBR as a strategy for community-based

inclusive development to assist in the mainstreaming

of disability in development initiatives and to reduce

poverty

- To support stakeholders to enhance the quality of life

through access to health, education, livelihood and

social sectors

- To encourage stakeholders to facilitated the

empowerment of PWDs by including them in

decision-making process

2. Development of CBR in Korea2. Development of CBR in KoreaInitiatives

Social sectors : Governmental pilot projects (Gov.

Fund)

- 1 urban model in Seoul

- 1 rural model in Chungbuk

- Ran by KSRPD, 1985~1988

Health : Civil Society’s project (German Fund)

- Ran by Jeonju Presbyterian Medical Centre, in the North

Wanju 1987-1995

Development of CBR in health & social sector

- Local authorities (1987~)

Registration & basic data collection

- Community Welfare Centers (1992~)

- Public Health Centers & Nat’l Rehab Hospital (1993~)

- Independent Living Centers (2001~)

- Nowon CBR Project (2003~)

Civilian Project by mobilizing local community resources

3. CBR services & delivery3. CBR services & delivery

Govern-ment

Health

Non-governmental

Localcommunities

Public Health Center

RehabHospital

Communityrehab center

IL Center

Special Education

Inclusive Education

Employmentcenter

Job training center

Service delivery

Education

LaborWelfare

ServiceArea

Support

VocationalRehab Center

4. CBR Stakeholders4. CBR Stakeholders

(WHO 2010)

Community

Leaders, teachers, health & community workers

Local government, NGOs, disability groups

Government, political leaders, media

5. Main service areas5. Main service areas Health

- 60/253 local public health centers(1:1 matching fund)

: General support for medical needs, rehabilitation services

: Cooperative activities with community resources

- National Rehabilitation Hospital

: Management of community public health centers

: Education and empowerment of CBR workers

: Partnership with community health service providers

: Research and development

Social Sectors

- 191 Community Disability Welfare Centers

: Physical therapy and social education

: Counseling, financial and housing support

: Home-visit outreach service

Social Sectors

- 178 IL centers

: Coordinating personal assistant service

: Peer-group counseling, self-help groups

: Provision of vehicles for PWDs’ outings

: Repairing and renting assistive devices

: Training basic living skills and awareness on

disability rights, enabling independent living

10

16

21 8

6

12

12

14

4

8

5

43

13

11

5

Seoul

Gyeonggi

Incheon

Daejeon

Chungnam

Jeonbuk

Gwangju

Jeonnam

Jeju

Kangwon

Chungbuk

Gyeongbuk

Daegu

Busan

Gyeongnam

53

5

10

6

3

7

5

4

4

15

15

2

35

7

5

3 2 Ulsan

IL 178

CDWC 191

Education - Special Schools

- Inclusive Schools

: Deinstitutionalizing children with disabilities

: Unification of general and special education system

※ Evening schools run by DPOs

- 45.2% of ‘persons with disabilities’ do not finish

primary school

- Open to all ‘persons with disabilities’ (beyond age

and disability types)

Employment

- Korea Employment Agency for the Disabled

: Assist ‘persons with disabilities’ to enter

mainstream labor market

- Vocational Rehabilitation Centers

: Enable people with severe disabilities to work

• 422 centers across the country (2011)

• Workfare centers, sheltered workshops, vocational

training centers

6. CBR Matrix 6. CBR Matrix (WHO, 2010)(WHO, 2010)

Towards Community-based Inclusive Development

CBR Matrix

Secondary &Higher

CBR goals

CBR areas

Public Health Center Schools Community Based Rehabilitation Centers

Independent Living Centers Vocational Rehabilitation Centers Others (Gos, NGOs and Business sectors)

Promotion

Prevention

Medical care

Rehabilitation

Assistive

Early childhood

Primary

Non-

Life-long

Skills development

Self-employment

Financialservices

Wage

Social protection

Relationships

Personal assistance

Culture &

Recreationleisure, sports

Justice

Advocacy &

Community

Political Participation

Self-HelpGroups

DPOsdevices

formal

Marriage, family

learning

art

communication

mobilization

Health Education Livelihood Social Empowerment

Employment

Overview : Youth and young adults (10-29 years of age)

with disabilities or those with family members with

disabilities request necessary assistance to achieve their

short/long term “dreams”

- Long term assistance

- Customized support & support of dreams initiated by the

participants

- Collaboration and long term case management between

different stakeholders (mobilizing community resources)

7. Case Study – “Dodream”(KSRPD)7. Case Study – “Dodream”(KSRPD)

7. Case Study – “Dodream”(KSRPD)7. Case Study – “Dodream”(KSRPD)

New “dreams”

: Home visits

to ensure

feasibility &

prevent

overlapping

support

Gather community

support through online

funding and individual

supporters/organizations

“Dreams”

accomplished

: Customized support

and long term case

management

Overall ProcessOverall Process

7. Case Study – “Dodream”(KSRPD)7. Case Study – “Dodream”(KSRPD)

Number of Male/Female Beneficiaries

M F

Number of Applicants and Beneficiaries

Applications Beneficiaries

Statistics (2010)Statistics (2010)

Number of Male/Female Beneficiaries

Number of Applicants and Beneficiaries

7. Case Study – “Dodream”(KSRPD)7. Case Study – “Dodream”(KSRPD)

Number of Beneficiaries (by disability type)

IntellectualOthe

rMultiplePhysical

Visual

Brain lesion Language HearingAutistic

Facial

Renal

Statistics (2010)Statistics (2010)

Number of Beneficiaries (by type of assistance )

Education Arts Medical Culture/LeisureImproving living

environmentIncome

generation

7. Case Study – “Dodream”(KSRPD)7. Case Study – “Dodream”(KSRPD)

Statistics (2010)Statistics (2010)

Name : Young Gwang Kim

Type of Disability : Physical

(Muscular Dystrophy)

Dream : To become an international court judge.

Type of Assistance

- In 2007, received a shower gurney and hospital bed to assist him while studying for

the university entrance exam.

- In 2009, after receiving admission to a top level university in Korea (Sogang), was

able to receive a laptop computer to help him in his studies.

7. Case Study – “Dodream”(KSRPD)7. Case Study – “Dodream”(KSRPD)

8. Challenges8. ChallengesAt governmental level

- Need for a “CBR Case Manager” :

Collaboration & Facilitating various resources

- Securing government’s political commitment for CBR

- Stronger national policies and strategies

- Awareness raising on CBR

Need to strengthen national level support through policies,

coordination and resource allocation

Need for rights based approach for CBR

At non-profit organizational level

- Understanding CBR & Obtaining external funds

- Ensuring cooperation among local organizations

(public health centers, local administrative body,

community welfare centers, rehabilitation centers,

private health/medical/social centers)

Participating in CBR trainings

Inter-agency consortium for grants and funding

applications

At community level

- Forming focus groups

- Motivating communities

Sharpening sensitivity to community needs.

Ensuring inclusion of PWDs and their families in

CBR projects

CBR is for everyone in the community,

Including persons with disabilities

Thank you~