A Need Assessment of Health and Welfare among the Disabled For Community Based Rehabilitation in Jeju
The Importance of CBR
The number of people with disabilities is increasing. War injuries, landmines, HIV/AIDS, malnutrition, chronic diseases, substance abuse, accidents and environmental damage, population growth, and medical advances that preserve and prolong life all contribute to this increase. These trends are creating an overwhelming demand for health and rehabilitation services. (WHO, 2005).
Rehabilitation is defined as the recovery of handicapped people’s functional abilities to the highest degree through comprehensive medical, social, educational, and vocational training.
One of the traditional rehabilitation methods, institution-based rehabilitation (IBR), fulfills only 2-3% of rehabilitation demand despite its high cost. Institution-based rehabilitation serves as an important medical system for special examination, surgical treatment, and other special treatments. However, it focuses only on individual disabilities without paying attention to their families or local communities. The biggest disadvantages include high cost, poor accessibility to rehabilitation facilities, and lack of qualified manpower (WHO, 1994). To overcome these limits, the WHO adopted Community-Based Rehabilitation (CBR) as a new rehabilitation method.
Only about 10% of treatment for the disabled requires the help of rehabilitation specialists. 20% of the cases can be dealt with by ordinary experts and the remaining 70% can be solved by the patient themselves, by their families, and by their communities, according to one report (Yoon, 2003).
Early discovery of disability, a strong will for rehabilitation, bedsore treatment, urine and feces disposal, improving the house layout, and simple treatments are included in the treatment needs for the disabled. CBR, rather than IBR, is better suited to meet those needs since CBR utilizes the manpower of people with disabilities, their families, and the local community. (WHO, 1995, Yoon, 2003).
The involvement of the local community is stressed not only because of its easy accessibility, efficiency and effectiveness. It is important that the local community be able to accept people with disabilities as its members and provide them with medical services, and that ultimately both the community and the disabled can become responsible for each other. In other words, the community will be able to take rehabilitation efforts more seriously and people with disabilities will also be able to find their places in the community (Kim, 2003). It is very important to normalize their membership in the community. CBR can be seen as a strategy and philosophy related to rehabilitation. CBR is a multi-sector strategy, fully supported by the WHO, aimed at improving the lives of the disabled. The widely supported strategy has been in place for more than twenty years and is being implemented by Member States and other UN Agencies (WHO, 2003). CBR is a strategy for giving equal rehabilitation services to people with disabilities, thereby helping to achieve social unity. CBR is implemented through concerted efforts in health, educational, vocational and social services made by the disabled, their families, communities, health organizations, relevant government agencies, and NGOs. (WHO, 2004) In short, CBR requires collaboration between the educational, employment, construction, transportation as well as health and social welfare services sectors.