2 nd COSI Annual Symposium Rehabilitation Franklin Daniel Manager - Community Based Programmes Venu Eye Institute & Research Centre

2 nd COSI Annual Symposium Rehabilitation Rehabilitation includes all measures aimed at reducing the impact of disability for an individual, enabling him / her to achieve independence, social integration, a better quality of life and self actualization Dr.E.Helander

2 nd COSI Annual Symposium Situation Analysis Source: NSSO Rounds 47 th in 1991 and 58 th in 2002.

2 nd COSI Annual Symposium Economic burden due to blindness in India Average working years lost due to adult blindness is 10 years. The life expectancy of a blind child is to be 50 years, resulting in a loss of 33 working years. 10% of the productive time of one economically productive member goes to care the blind person. 20% - 40% of all those who are blind are economically productive. Source ; Economic burden of blindness in India’1998, BR Shamanna

2 nd COSI Annual Symposium Situation Analysis Source: NSSO Survey Round 47 th and 58 th in 1991 and 2002.

2 nd COSI Annual Symposium Situation Analysis Source : Disability status in India All are situated in urban area. Less accessible to 83% of disabled people in India.

2 nd COSI Annual Symposium Present scenario Types of Rehabilitation Institution Based Rehabilitation (IBR) Residential Day care centers Shelter workshops Community Based Rehabilitation (CBR)

2 nd COSI Annual Symposium Present scenario In Contrast to IBR programmes, the CBR programmes are more economical and socially desirable in Indian condition. IBRCBR Less coverageMore coverage Age limitsFor all age groups Institution based tradesCommunity based trades Isolated from communityIntegrated into community Less community involvementMore community involvement - Unit cost is more (Rs to 60000) Unit cost – less (Rs.800 to 1000) - Quality care for Persons with Multiple disabilities Comparatively less

2 nd COSI Annual Symposium Present scenario Community development / comprehensive Eye care strategies are formed without including rehabilitation –Rehabilitation is an important component of Community Development

2 nd COSI Annual Symposium Changing trend Source : WHO CBR Matrix – 2004,06,08 Medical Model Social Model Prevention Promotion Curative Rehabilitation Education Livelihood Empowerment Social +

2 nd COSI Annual Symposium COMMUNITY BASED REHABILITATION EDUCATIONLIVELIHOODEMPOWERMENTSOCIALHEALTH PROMOTIVE PREVENTIVE CURATIVE REHABILITATIVE ASSISTIVE DEVICES EARLY INTERVENTION NON-FORMAL HIGHER SPECIAL/ TRANSITORY LIVING SKILLS DEVELOPMENT INCOME GENERATING ACTIVITIES ACCESS TO FINANCIAL SERVICES OPEN EMPLOYMENT ECONOMIC/ CONTRIBUTION & SOCIAL PROTECTION SELF-HELP GROUPS DISABLED PEOPLE’S ORGANIZATION SOCIAL MOBILISATION POLITICAL EMPOWERMENT LANGUAGE & COMMUNICATION LEGAL PROTECTION CULTURE & RELIGION SPORTS & LEISURE RELATIONSHIP MARRIAGE & FAMILY PERSONAL ASSISTANCE FORMAL SCHOOL

2 nd COSI Annual Symposium Identification, Prevention, Promotion Referral Clinical Assessment / Intervention Need and age based Education Livelihood Empowerment Social Advocacy Counseling Functional Assessment Community Development activities Hospital / curative service centre Curable Treatment Incurable NetworkingNetworking

2 nd COSI Annual Symposium Capacity building & Insurance systems Community Development interventions by networking, forming groups Rehabilitation services - VI Cross disability Preventive & Promotive services Curative outreach services Need Based Growth Venu’s Community Based Programmes

2 nd COSI Annual Symposium Venu’s CBPs Covered 1.8 M & 2.58 M being covered –CBR for Visual impairment –CBR for Cross disability Working with persons with –Vision impairment –Hearing impairment »Children and young adults –Locomotor disability –Community Eye Health –Urban Slum project with Community Development interventions –Comprehensive Diabetic Retinopathy project –Comprehensive Glaucoma Project –Integrated Education units : 12

2 nd COSI Annual Symposium Future concepts District level – Comprehensive eye services : A Multi stakeholders approach Community eye health Insurance Comprehensive CBR - for all disabilities

2 nd COSI Annual Symposium Roles AgencyExpected Roles CommunityField staff, Door to Door survey, Training, Referral, Promotion, DPOs, SHGs Curative Centre / Eye HospitalTraining, Screening, Curative services Devices NGOsFacilitation, advocacy, training, Networking SSA / Education departmentProvision of Inclusive education Social welfare departmentSupportive services Red Cross SocietyAssistive Devices GovernmentImmunization, Water sanitation, Health / eye health services

2 nd COSI Annual Symposium To conclude.. Rehabilitation is an integral part of Community Development activities. –CBR is the only medium to reach 83% of rural blind population. 100% Door to door survey through CBR Community ophthalmology or comprehensive eye care cannot be holistic without including rehabilitation. Rehabilitation centers should have preventive, curative and promotive services. Eye hospitals should have rehabilitation services.

2 nd COSI Annual Symposium Thank You