Community Based Rehabilitation : The Korean Model

1. Community Based Rehabilitation : The Korean Model Dr. Il-Yung Lee RI Korea, National Secretary RI Vice President, Asia Pacific Region

2. Contents • Evolution of CBR • Development of CBR in Korea • CBR services & delivery • CBR Stakeholders • Main service areas • CBR Matrix • Case Study • Challenges

3. 1. Evolution of CBR • First 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

4. 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

5. 2. Development of CBR in Korea • Initiatives 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

6. 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

7. 3. CBR services & delivery Public Health Center Special Education Rehab Hospital Health Education Inclusive Education Non-governmental Govern-ment Local communities Employment center Community rehab center Job training center Welfare Labor IL Center Vocational Rehab Center Service delivery ServiceArea Support

8. 4. CBR Stakeholders Government, political leaders, media Local government, NGOs, disability groups Leaders, teachers, health & community workers Community (WHO 2010)

9. 5. 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

10. Social Sectors - 191 Community Disability Welfare Centers : Physical therapy and social education : Counseling, financial and housing support : Home-visit outreach service

11. 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

12. 10 43 21 8 8 12 6 5 12 4 16 14 7 Kangwon Seoul 53 Gyeonggi 35 5 Chungbuk Incheon 7 4 Gyeongbuk Daejeon 5 4 Daegu Chungnam 2 3 2 Ulsan Jeonbuk 5 13 15 Busan Gwangju 10 11 15 Gyeongnam Jeonnam 6 Jeju 3 5 IL 178 CDWC 191

13. 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)

14. 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

15. 6. CBR Matrix (WHO, 2010) Towards Community-based Inclusive Development CBR Matrix Health Education Livelihood Social Empowerment CBRgoals Promotion Early childhood Skills development Personal assistance Advocacy & CBRareas communication Self- employment Relationships Prevention Primary Community Marriage, family mobilization Secondary & Higher Employment Wage Medical care Culture & Political Participation art Financial services Rehabilitation Non- Recreation leisure, sports Self-Help Groups formal Assistive Life-long Social protection Justice DPOs devices learning Public Health Center Schools Community Based Rehabilitation Centers Independent Living Centers Vocational Rehabilitation Centers Others (Gos, NGOs and Business sectors)

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

17. 7. Case Study – “Dodream”(KSRPD) Overall Process 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

18. 7. Case Study – “Dodream”(KSRPD) Statistics (2010) Number of Male/Female Beneficiaries Number of Applicants and Beneficiaries Number of Male/Female Beneficiaries Number of Applicants and Beneficiaries M F Applications Beneficiaries

19. 7. Case Study – “Dodream”(KSRPD) Statistics (2010) Number of Beneficiaries (by disability type) Intellectual Physical Visual Brain lesion Autistic Language Hearing Facial Renal Multiple Other

20. 7. Case Study – “Dodream”(KSRPD) Statistics (2010) Number of Beneficiaries (by type of assistance ) Education Arts Medical Culture/Leisure Improving living environment Income generation

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

22. 8. Challenges • At 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

23. 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

24. At community level - Forming focus groups - Motivating communities  Sharpening sensitivity to community needs.  Ensuring inclusion of PWDs and their families in CBR projects

25. CBR is for everyone in the community, Including persons with disabilities Thank you~