Hesperian Health Guides
Kinds and Levels of Village-Based Activities
HealthWiki > Disabled Village Children > Chapter 45: Starting Village-Based Rehabilitation Activities > Kinds and Levels of Village-Based Activities
There is no formula or blueprint for starting a village rehabilitation program. How things get started will depend on various factors: the size of the village, the number of children with disabilities and the nature of their disabilities, the interests and talents of parents and other persons, the resources available, the distance and difficulties for getting specific rehabilitation services elsewhere. Also consider the possibilities for getting assistance from rehabilitation professionals, craftspersons, health workers, schoolteachers, and others with skills that could be helpful.
It is important that most rehabilitation activities take place at home with the family members as the primary rehabilitation workers. And even where plenty of money and professional services are available, the home and community are still the most appropriate place for most of the rehabilitation of most children with disabilities. For home-based rehabilitation to be effective, parents need community support, friendly encouragement, and carefully selected and prepared information from rehabilitation professionals. Community support can be developed through meetings open to everyone interested in working together to improve life for people with disabilities. Involving neighbors in a project like building a playground for all children can also build support and encouragement for rehabilitation in the community (see Chapter 46).
At times, parents will need assistance from rehabilitation and medical workers with different skills. A good arrangement, perhaps, is a referral chain, starting with rehabilitation in the home with guidance from a small community center run by local, modestly trained workers. If possible, the center has close links with the nearest low-cost or free orthopedic hospital and professionally-run rehabilitation center, to which the relatively few children with disabilities requiring surgery or complex therapy can be referred. Outside professionals (orthotists, therapists, and others) can help by making periodic teaching visits to village rehabilitation centers. They can also invite village workers to visit and apprentice with them in their city shops and clinics. (Apprentice means to learn by helping someone more skilled.)
Some villages will be too small or lack the resources to start their own community rehabilitation center. However, it has been found in several countries that once a modest center in one village opens, the word spreads. Children with disabilities and their families soon begin arriving from surrounding villages. In time the rehabilitation team may be able to help people with disabilities and their families in neighboring villages to organize their own sub-centers. Workers with disabilities from these sub-centers can learn by “apprenticing” at the original center.
The above “ideal” is more or less the way Project PROJIMO in Mexico works, although with certain difficulties and obstacles.