Stephan Tafrov: I call the meeting to order
Sixth Session of the Conference of States Parties
To the Convention on the Rights of Persons with Disabilities
Conference Room 4
Thursday, July 18, 2013
Stephan Tafrov: I call the meeting to order. Good afternoon, ladies and gentlemen. We resume the general debate. The first speaker on my list is the Permanent Representative for Greece speaking for the Greek delegation. You have the floor, sir.
Greece: Good afternoon and thank you, Mr. Chairman. Greece aligns itself with the European Union. Over the last half century, the world has made significant progress in the promotion of human rights.
But identifying whom and how to protect and assist has become more complex. Persons with disabilities still face discrimination. And our society should direct its full attention and priority.
Greece is proud of the fact that despite the financial crisis, our commitment to disability rights has never been stronger. Let me underline some of the measures we have taken.
We have published a comprehensive guide for persons with disabilities that help them become aware of their rights.
Secondly, funds have been allocated for the transportation of disabled children to specially equipped schools.
Thirdly, accessibility for persons with disabilities to public works under development is now mandatory.
Furthermore, the program of disability in municipalities has been established. This is assigned to local mayors while there is an overseer on in national level.
This is an example of local action bankrolled by national resources and political will as well as providing institutional structure for community based rehabilitation of disabled persons.
We know this is not enough. There is much crucial work that still needs to be done, especially for women and children with disabilities.
But it is the overall conviction that disabled people have the same rights and entitlements that non-disabled people do that presses us forward.
We have to bear in mind these are inalienable rights. Lack of available funds is only an excuse not to make significant progress to not fulfill our obligation to Persons with Disabilities.
We need a will and commitment of national agendas. NGOs and civil society organizations are commended for doing their part for the support of the disability cause.
I would like to take this opportunity to acknowledge the work of the International Disability Alliance, whose leadership on this issue has provided tangible results.
We should always bear in mind that the spirit and the letter of the Convention are to constantly engage with persons with disabilities and to do nothing for them without them.
Encouraging private sector entities to partner with public sector and civil society is yet another cost-effective method in pursuing this goal. It will go a long way in ensuring economic empowerment of disabled people.
Disabilities were left out of the Millennium Development Goals the last time around. But moving forward with the post-2015 agenda, we must refine our goals and focus on the alliance of disabled people should be the central tenet of the SDGs.
Our focus on persons with disabilities demonstrates not only a desire to correct injustices against them but is a signal of the progress we have made in other areas that allows us to deal with these problems head on.
Therefore, the international community should seize every opportunity to include disability as a cross-cutting issue in our global agenda. Thank you.
Stephan Tafrov: I thank the distinguished representative of Greece. Before I give the floor to the next speaker, I would like to thank you for adhering to the 3-minute limit we all have. I would like to appeal to the rest of the delegations to adhere to the same 3-minute limit.
[Speaking in Russian; no translation.]
Russia: [In progress] ...designed to protect the rights and interests of 15% of the inhabitants. Here in New York, the ratification of the Convention on the Rights of Persons with Disabilities signed in 2008 was signed and deposited with the Secretary-General. This concluded Russia's accession to the document.
This was a significant step for Russia because it provided an impetus to create legal, financial, economic, administrative, and other conditions for ensuring equal opportunities for persons with disabilities.
Leading to the ratification, 10 new legislative acts and 13 amendments to federal laws have been adopted regarding the creation of unimpeded access for persons with disabilities, enhancing the level of their employment and the quality of medical services.
The role of the process has been played by the commission in the president's office of the Russian Federation on disabled person's affairs. This includes executive and legislative power as well as public associations.
Work on the practical implementations is being conducted in accessibility adopted by the Russian Federation with total financing of $3 billion.
The goal of this program is creating unimpeded access by persons with disabilities to all necessary sites and services for a normal life.
The increase by a factor of 8 of the number of educational institutions for individuals with disabilities. The creation of an additional 300,000 new jobs. The regular enhancement of the size of pensions for persons with disabilities. And the active expansion of the use of subtitles on national television. Adapting the Internet to persons with disabilities. And providing electronic forms of state processes. The modernization of technical needs given the state of art of this area.
Since 2011, Russia has been improving social expertise and rehabilitation of persons with disabilities aimed at enhancing objectivity in determining disability in the rehabilitation process.
There is new work taking into account the national classification for persons with limited activity and health. Thus, the draft for the new classifications and criteria for determining disability is a pointed based system.
Further information has been given for persons with disabilities. This implementation of a range of measures designed to enhance knowledge of society regarding questions of persons with disabilities and their integration into society.
There will be substantive information received during the conference. I thank you.
Stephan Tafrov: Thank you, distinguished representative of the Russian Federation. I again report my request to adhere to the 3-minute limit. I remind everyone that full statements can be posted on PaperSmart.
The next speaker on my list is the distinguished representative of Turkey. You have the floor.
Turkey: Thank you. Turkey would like to extend its appreciation to the Bureau and the secretariat. Turkey ratified the CRPD in 2009. It is the main document that guides its policies throughout the country.
The General Directorate of Services operates at central and provincial levels. A national action plan is under preparation to promote the implementation of CRPD.
Meanwhile, projects are being carried out to enhance data collection methods and better adherence of the Convention.
We have some important buzzwords when addressing the issue of persons with disabilities. The first is education, including early and inclusive education.
Equal opportunity and education has development implications and builds healthy democratic societies. The education of children has increased 100% since 2004.
Transporting teachers to children with special needs is effective.
Accessibility is another keyword. The Disability Law in 2005 has led to significant improvements in this respect in terms of making public buildings, transportation systems, roads, sidewalks, and public areas accessible to persons with disabilities.
In fact, in 2010, it was declared the Year of Disability Actions for All with the implement of a nationwide disability plan.
Turkey has been fighting discrimination against persons with disabilities since 2009. In cooperation with civil society, surveys have been conducted. The results have been used to enhance implementation.
The full implementation of CRPD is only through raising rights to all parts of the society. Turkey has national awareness raising seminars which targets public authorities, civil societies, etc.
Through incremental legal and practical steps since the 1980s, participation in decision making issues has improved and was included in the 2005 disability law.
The inclusion of civil society, the media into disability policies is not only useful in terms of benefiting from their expertise but also contributes to awareness raising.
I would like to take this opportunity to reiterate my gratitude to share best practices among states parties and your contributions across the world. Thank you.
Stephan Tafrov: Thank you, distinguished representative of Turkey. I now give the floor to Costa Rica.
Costa Rica: Thank you, Chair. As a social state based on the rule of law wishes to reiterate its commitment on the Convention on the Rights of Persons with Disabilities. Our country has made progress towards implementation of the Convention as follows.
Accessible housing. Costa Rica ranked first among Latin America and the world in developing legislation on accessible housing.
In justice, the country's supreme court adopted the rules of Brasilia for persons with disabilities. This ensures improved condition for access to justice to this group.
In terms of education, in April of this year the Convention for Networks of Inclusive Education was signed. Line 949 was adopted about a year ago recognizing Costa Rican Sign Language as a mother tongue.
In terms of labor, we have a national plan for labor insertion for persons with disabilities and we have implemented a program for employability and opportunities for youth with disabilities.
In the Year of International Cooperation under the Leading Entity on Disabilities, we have conducted projects for the implementation of community-based inclusive development strategies.
This is for the vulnerable population. And this was conducted together with help from the International Cooperation Agency of Japan and the Spanish Agency for International Cooperation and Development. We have established strategic partnership and triangular cooperation with countries in Latin America.
Last February we conducted inclusive development in a community based way in Costa Rica. One of the main results was a letter of intent to promote and support implementation of inclusive development initiatives benefiting persons with disabilities in the region.
We should also note that one of the areas in which Costa Rica has been working is the strategy for inclusive development for rehabilitation and special education. This strategy is based on the states implementing inclusive development and providing the services this relates to in order to help persons with disabilities.
We also have an approach that is a bottoms-up approach to help persons in that community identify their problems and needs. The approach also sets up governance approaches.
We work with all members of the community and public and private partnerships with the leading entities. We are boosting scarce resources.
This strategy aspires towards the inclusion of all persons of the community, avoiding segregated measures and actions for persons with disabilities. The potential of this must be recognized.
My delegation wishes to note the efforts and commitments of Costa Rica yet we must note this is constantly changing and developing. This will continue to be implemented over time.
Stephan Tafrov: Thank you. I give the floor to the distinguished representative of Morocco.
Morocco: Mr. Chair, I would like to express in the name of the Moroccan delegation I would like to commend this conference. I would like to give you an idea about the relentless efforts of Morocco.
Disability has been a priority in Morocco in the Constitution of Morocco as of 2011. Chapter 4 of the Constitution came as a safeguard for persons with disabilities. Given this source, a new normative system has been put in place to ensure the rights of persons with disabilities by using legal provisions and special laws.
Recently, there was a draft for a bill to promote the rights of persons with disabilities. That is on the legislative agenda of the government for 2013. The government of Morocco is in the process of having a public policy for the rights of persons with disabilities. This is based on a partnership and the inclusion of all stakeholders in the field.
This is in the framework of having a government action plan that will start in 2014. There are sectoral programs stemming from this plan. Financial and human resources have been allocated to this plan.
There is a national survey about disability. The findings of which together with the findings of the census will be the foundation of a program sensitive to the needs of persons with disabilities.
Persons with disabilities have an important and significant role in advocating their issues and defending their rights. The Moroccan kingdom is involved in protecting the rights of persons with disabilities. We are pleased to state that we have joined the convention about the rights of people with visual impairments. This was held in Morocco last month.
On the other hand, Morocco welcomes the high-level meeting that will be allocated to have inclusive development programs for persons with disabilities. I would like to say that my country will submit a report about the implementation of the CRPD within this year to reflect the status of persons with disabilities in my country and the efforts exerted to advance their rights.
Stephan Tafrov: I thank the distinguished representative of Morocco. I now give the floor to the representative of Syria.
Syria has the floor.
I'm afraid that the Syrian delegation is not there. I give the floor to the distinguished representative of Peru.
Peru: Chair, at the outset may I convey to you my appreciation for your work as well as to other members of the bureau and to the secretariat of this Sixth Session of the Conference of States Parties.
In Peru, in April 2012, we had our first review to the committee on the convention on the rights of persons with disabilities in Switzerland.
December 24, 2012 Peru implemented its legislation to the convention. We should also note that as to the structural aspect in Peru, we have taken important measures. The central government has ensured a national system for the integration of persons with disabilities. This is under CONADIS, a body that handles persons that are vulnerable.
We have set out this program and others plans. We should also note that the annual budget of Peru for 2012-2013. Every year we have allocated public spending at all levels of government of more than $200 million for disabilities. In 2013, we have policies in place under the new policy for indicators for efficiency and for spending towards the education, health and employment of persons with disabilities.
This body, CONADIS, since July 18, 2012, has been conducting interesting public policy to help employ persons with disabilities in the public and private spheres under I Am Capable. This employs a number of persons with disabilities.
I should also inform you that CONADIS has been managing and is finalizing a pilot program in one of the 26 regions of Peru a model for activities. The first part of this is to take a survey of all persons with disabilities. The second step is to conduct a study, house by house. In order to ensure the second phase of this survey we need to meet the needs of persons with disabilities.
Peru presented a report on the specialized body about its investment of more than $13 million. This has provided assistance to a number of different households and a significant number of persons living in Peru as there are a great number of persons with disabilities in my country.
8.2% of that total is persons with disabilities under the age of 15. Ages 15-24, there are 150,000 in that age group.
794 persons of an adult age are disabled. We have conducted a number of policies for persons with disabilities falling under our budget. This survey ensures that over 50% of persons with disabilities benefit from social security.
Many Peruvians are unemployed. A great number of persons have disabilities and need our help as well. Thank you.
Stephan Tafrov: I thank the distinguished representative of Peru and give the floor to the distinguished representative of Luxembourg.
Luxembourg: Following the ratification of the Convention of 2011, the government has finalized a five-year plan of action. Each year emphasis is made on a different subject in 2013; particular attention was given to empowerment.
A dialogue of equal-to-equal is predicated on equality.
The availability of information is working hand-in-hand with a center for easily accessible language.
The law dealing with persons with disabilities is designed to promote the economic independence of persons with disabilities. The law provides for the establishment of a system for employees with disabilities.
There are interventions for those who cannot earn a living with regular paid salary work.
Along these lines the government supports the functioning of the service life academy, which provides ongoing training to persons with disabilities.
Our country is now working on two major and important projects in the policy of persons with disabilities. First of all, replacing the system of supervision to a system of support. Second, by expanding the field of application of the law on accessibility of buildings and the adoption of norms of accessibility to the demands of the Convention.
These are a few measures and initiatives implemented. We will continue to work along that path and hope that through the exchange of good practices we will all make progress in working towards an inclusive society.
Stephan Tafrov: Thank you. I now have the pleasure to give the floor to the distinguished representative of the United Kingdom.
United Kingdom: Since last year the UNITED KINGDOM has made further progress on the rights of persons with disabilities. This month, July, sees important milestones. The first and second of July was the publication of the UNITED KINGDOM's disability strategy: Fulfilling Potential.
Disabled people should be able to achieve their aspirations and play a full role in society. Fulfilling Potential promotes new ways to work and deliver new outcomes. This has been developed with disabled peoples organizations.
Fulfilling Potential includes an action plan that includes the whole of government and beyond. The action plan is encouraging and supporting the work of the new Disability Action Alliance.
Fulfilling Potential has used a wide range of data from a detailed analysis published early this year. The government has worked to development an outcome of an indicator framework to monitor progress nationally. Recognizing that most policies are delivered at a local level, we are working with disabled peoples organizations to develop a tool kit.
Working with disabled people and hearing their voices is an important theme in the UNITED KINGDOM's approach. The UNITED KINGDOM aligns itself with a statement made by the European Union. The second milestone this month will be the publication of a report into the 2012 London Olympic and Paralympic games. The themes of the legacy are complementary to Fulfilling Potential.
The third milestone came about eight hours ago with the launch of a two-year advertising campaign to encourage employers to employ disabled people. Employers were able to discuss what they perceived to be the barriers in employing disabled people.
Alongside the disability campaign there is a new employment strategy for disabled working with disabled peoples organizations and others to better understand the barriers.
The UNITED KINGDOM remains very willing to share its expertise and experiences. We welcome the opportunity to learn about the approach of others.
Stephan Tafrov: I thank the United Kingdom and now give the floor to the distinguished representative of Canada.
Canada: I would like to thank you for the opportunity to address the Conference of States Parties to the Convention on the Rights of Persons with Disabilities.
As a federation, Canada's framework to implement the Convention is multi jurisdictional. We are committed to reducing barriers and continuing to work towards an inclusive society for all and where persons of all abilities equally participate in life.
Canada recognizes the contributions persons with disabilities can and do make to the economy. Through investments, Canada is working to empower persons with disabilities to reach full potential as well as investing in long-term growth of the country.
Governments alone cannot do this. That is why we created a panel last year. The panel reported on best practices and barriers to employment of persons with disabilities.
This year, the government of Canada announced support for an employers' forum managed by and for employers to facilitate best practices of hiring and retention of persons with disabilities.
I will continue in French. The government of Canada has several programs to assist persons with disabilities including the means to find jobs.
Programs provide financing to employers to hire persons with disabilities capable of working but who have not found a job and who perhaps do not have acquired expertise.
Similar or complementary programs are offered that provide significant support in the area of education, health, employment, lodging, and other areas.
We have also invested $350 million between 2001 and 2011 in programs for international development for issues dealing with persons with disabilities including prevention measures, health, school enrollment, and community re-adaptation and formation based on competence and employment for persons with disabilities.
It is important to share experience on the international level and to engage in partnership to learn from our national and international partners.
Canada is gratified by the prospects of moving forward together and to continue to build an inclusive society for everyone. Thank you.
Stephan Tafrov: I thank Canada. I will now give the floor to the last speaker on my list for today. This is the distinguished representative of Albania.
Albania has the floor. Is anyone from Albania? That doesn't seem to be the case. Now I am giving the floor to the distinguished representative of Ecuador.
Ecuador, you have the floor.
Ecuador: Thank you, Chair. The Permanent Representative of Ecuador will make his statement tomorrow. So we don't wish to prolong the deliberations here.
Stephan Tafrov: I will now hear from Bosnia Herzegovina.
Bosnia Herzegovina: Thank you. I congratulate you and other members of the Bureau of the Sixth Session of the Conference of States Parties.
The promotion and protection of the rights of persons with disabilities remains of the utmost importance to Bosnia Herzegovina. We welcome positive advancements of the global agenda in the framework of the Convention on the Rights of Persons with Disabilities.
We have ratified the Convention on the Rights of Persons with Disabilities and optional protocol in March 2010 without reservations. We prepared and submitted the initial report on implementation of the Convention to the Committee for the Rights of Persons with Disabilities in accordance with the guidelines of this committee.
We emphasize that the civil society sector participated in the preparation of this important report as well.
In 2003, the Council of Ministers passed the rules of participation of persons with disabilities. Aiming to improve the mechanism of the rights of persons with disabilities and a system of coordination between the responsible institutions on the state level, the Council of Ministers passed the decision to pass the Council of Persons with Disabilities.
This council consists of 20 members with a 4-year mandate. It was actively involved in the above mentioned initial report. There is inclusion of all persons with disabilities, so we adopted the document Disability Policy in Bosnia Herzegovina in 2008.
The law of prohibition of discrimination was passed, which contains non-discriminatory prohibitions passed prior. A discriminated person can exercise his or her own rights through the judicial system.
We are continuing to fully ensure the civil, economic, political, and cultural rights of persons with disabilities. Bearing all of this in mind, we emphasize that we have identified the need to provide active participation in the work of political parties and the decision making process at all levels.
Specific encouragement is given to organizations of persons with disabilities to participate in public debates related to documents of importance for all citizens.
Persons with disabilities in our country have received recognition in support activities. This is best seen from the fact that persons with disabilities are present in all contexts for the best of life. In addition, our country has a Para-Olympic committee, Special Olympics board of governors and others.
The needs of persons with disabilities have to be included as a part of the Millennium Development Goals. Therefore, Bosnia Herzegovina echoes the request to mainstream disability into the post-2015 development agenda.
We look forward to the high-level meeting of the General Assembly under the realization of the Millennium Development Goals and other agreed goals. We hope the heads of state and government will affirm the commitment of the international community through the adoption of an outcome document.
In conclusion, allow me to confirm my country's determination to ensure full enjoyment of all rights of persons with disabilities, their economic empowerment, and full inclusion in all aspects of the society.
Thank you.
Stephan Tafrov: I thank you. This was the last speaker on the list for today's general debate. We will resume the general debate tomorrow at 10:00 a.m. sharp. I close the session.
Now, I ask the members of the panel for the next informal panel to join me so we can start as soon as possible. Thank you.
Ladies and gentlemen, it is my pleasure and honor to open this informal panel with a very important subject: Community-based rehabilitation and habilitation for an inclusive society.
It is a great honor to have our colleague and friend and very well-known expert on the subject from Lebanon, Dr. Nawaf Kabbara, who represents International Disability Alliance, a very well-known NGO network of networks of persons with disabilities. It has made important contributions to the work of this conference.
Without further ado, ladies and gentlemen, allow me to start by making a few introductory remarks.
Speaking for Dr. Nawaf Kabbara, I think we can say that this discussion is a truly collaborative effort of states parties and disabled persons' organizations. We will try to make it as interactive and stimulating as possible.
According to the World Health Organization, community-based rehabilitation is a strategy for rehabilitation, poverty reduction that requires multi sectoral approaches. It is implemented through persons with disabilities, their families, and their communities with the involvement of relevant local authorities and the support of a wide range of stakeholders.
CBR programs contribute to the rights of persons with disabilities across a number of areas and activities. The aim is to reduce poverty, achieve social inclusion, and empower persons with disabilities.
The CBR comprehensive approach at the community level has a variety of concerns with persons with disabilities and their families such as community integration, education, health, employment, habilitation, and rehabilitation, adequate standards of living, etc.
Today, we are going to explore how the CBR strategy, which is implemented in more than 90 developing countries, contributes to adequate standards of living and social inclusion of persons with disabilities by fighting exclusion and discrimination.
The CBR approach focuses on marginalized groups of persons with disabilities and eliminates inequalities.
Let me offer a couple of questions. What are the advantages of the community-centered approach offered by the CBR of the Convention? Are there new data to reinforce the strategy in building disability inclusive societies?
I was reminded recently of the conclusions from the first executive meeting of the CBR Network in Bangkok in early July where a number of ideas and good practices were shared. I look forward to hearing from you and the panelists about all of these subjects.
How can we, the member states, the United Nations, and the international development organizations, promote further CBR as a strategy to ensure adequate standards of living and empower persons with disabilities?
I draw your attention to the questions in the background paper prepared by the secretariat for this discussion.
Now I am going to stop and introduce our first panelist from El Salvador, Ms. Violeta Menjivar, Vice-Minister of Health of El Salvador.
Ms. Menjivar, Her Excellency, is the Vice-Minister of Health for the National Council for Persons with Disabilities of El Salvador. She worked as a parliamentarian for 12 years. As president for the Commission of Public Health in the parliament, she contributed to the law for equal opportunities for persons with disabilities. You have the floor.
Violeta Menjivar: Thank you very much, Chair. Good afternoon everyone, from El Salvador, especially on behalf of the president of my country. El Salvador has 2.49 million people covering more than 21,000 square kilometers.
In April of this year, there were 253,000 persons older than 18 who have a disability. That number of persons has requested identity documents in the country. We have a population survey to identify the total number of all persons with disabilities by type and socioeconomic status.
El Salvador has an institutional legal framework which consists of ratification of the Convention of the United Nations and its optional protocol. The OAS Convention on Disabilities including ratification of the Ottawa Convention.
We have a national law for equal opportunities for persons with disabilities. This has been in place since 2000. The country has a guiding body for the policy of comprehensive care for persons with disabilities. It has an equal level of participation at the government level and represents families and communities with disabilities. It has government institutions with sectoral programs for persons with disabilities, such as in the Ministry of Health, the Ministry of Education, the Public Works Ministry, the Labor Ministry, and the Salvador Institute for Rehabilitation.
We also have a fund for the protection of persons with disabilities.
As a result of the armed conflict we have services for our armed forces.
There are prevention programs. We have a program for a human milk bank helping newborns. We have recently approved a law for breast milk. We have a program for education for children with visual impairment under the Ministry of Health and the Ministry of Education.
We have a program to prevent land transportation accidents and a fund to help accident victims. We provide resources for the prevention of land transportation accidents. We have approved an occupational risk prevention law.
The country has a national program for free vaccination thanks to the recent approval of the vaccination law. This ensures the quality of vaccinations and has a special fund for their procurement. We have eradicated polio in my country.
There is a national program for the early detection of hyperthyroidism to prevent impartment due to that disease. We have other programs for detection and early care for chronic kidney disease, diabetes, and other disorders.
The Ministry of Health has a new model of care that focuses on the individual, the family and the community. There are programs for detection, care and rehabilitation. Through its national network of hospitals and through teams of health communities we have a program for comprehensive care and an institute for this purpose for rehabilitation in the country.
We have an institute for the comprehensive rehabilitation for these persons. There is a rehabilitation unit within that institute. There is a fund for the protection of disabled persons that are disabled as a result of armed conflict. This is under the Peace Agreement.
There is a center for the professional rehabilitation of the armed forces which has a rehabilitation program for the armed forces who are disabled due to armed conflict. In this respect, the Ministry of Health has ensured implementation of a national emergency medical service to provide surgery in a timely way to avoid complications, disability and death where accidents occur.
In April of this year we approved the law for the national fund for care to victims of transport accidents. This is preventive in nature. As I mentioned earlier, there is also a fund for providing healthcare and financial assistance to those persons who have been disabled or to their family members in the event that they have passed away.
In my country we are currently setting up a program for the metropolitan area transport integrated system to ensure that transport is accessible and integrated, especially for persons with reduced mobility and persons with disabilities, persons who are pregnant, the elderly and others.
The country's strength in rehabilitation is that it is based on the community. We have undertaken significant efforts for rehabilitation at a community level. We have focused on rights, equal opportunities, participation and social inclusion of persons with disabilities.
Some of these efforts have been coordinated with state institutions and civil society organizations for persons with disabilities. The Health Ministry has been carrying out a care strategy that is community-based through 32 community teams for specialized care.
517 basic medical teams work throughout the country. These teams provide care in a cross-cutting nature. They provide occupational therapy, as well. The Ministry of Health has support from various institutions and community agencies of persons with disabilities, including an organization that works with parents. This program develops specific projects to improve the living conditions of children and young people who are disabled in order to ensure their social inclusion in a participatory way.
This community-based agency has carried out training and exchange of experience in rehabilitation in a community-based way with community staff specialized under the Ministry of Health. They have ensured community care and rehabilitation focusing on children with disabilities who have physical and mental impairments.
There have been activities conducted at various dates for persons with disabilities. There are support groups. There are peer support groups of persons with disabilities. There are groups for older adults, children and adolescents. There are local programs for physical rehabilitation, education, help with daily activities, language assistance, labor assistance in coordination with the Ministry of Education with municipal councils and their communal measures as well.
Community teams have been implementing technical measures by providing various aids in this regard.
Under the Ministry of Health there is a registry of persons with disabilities. Under a family sheet that registers this, there are consultations to ensure follow-up of persons with disabilities who require support of various kinds. The institute in my country for integral care has a pilot project for rehabilitation that is community-based in coordination with the Municipal Council, local associations of persons with disabilities, public school centers, labor agencies, women's agencies and others.
This integral body in my country emphasizes a strategy beyond providing merely medical care. This counts on the active participation of persons with disabilities, their family members and other stakeholders in the local community at the community level. We also have an institution for rehabilitation which helps blind people. It conducts programs with persons who are deaf-and-blind and otherwise visually impaired. They help them artistically and culturally.
Through the School Center for Blind People we provide training in the first three years of primary education. These are then integrated into regular public schools. The Ministry of Education has incorporated inclusive sports programs. The National University Institution in El Salvador is the only university that trains professionals in physiotherapy.
There is a private higher level education university which trains professionals for prosthetics. There is an institution that trains professionals in physiotherapy specializing in medicine.
One challenge is to harmonize with the framework of the rights of persons with disabilities. Another challenge is to ensure a survey to determine the number and type of disabilities, the economic conditions of persons with disabilities in El Salvador to ensure covering their integral care.
We must unify criteria for the qualification and certification for care of disability.
Public and private institutions must make reasonable changes and emphasize the services to ensure that persons with disabilities can enjoy their rights.
The next challenge is to conclude the updating of the technical norms for urban transportation.
We also need institutional strengthening for the guiding body of care.
Institutional strengthening of the rehabilitation institute and ensure it is a specialized institution providing care.
The next challenge is to expand the strategy of persons with disabilities and ensure that they participate at a cross-cutting level.
Next, to create an observatory dealing with disabilities.
Next, to have greater allocation of resources to strengthen implementation of rights of persons with disabilities.
Lastly, improved protocol with all stakeholders involved. Progress has been made to guarantee the rights of persons with disabilities. We will work to overcome inequalities and stigma that produce suffering for persons with disabilities. Thank you.
[Applause.]
Stephan Tafrov: Thank you for this presentation. This was a very comprehensive presentation. I am giving the floor to my co-chair.
Nawaf Kabbara: It was in India where I met him the first time. He was the mortar behind the Convention of CBR global. He was moving all around to make sure that the conference would be a success. He was the most important mortar behind the product of this conference.
The second speaker is Mr. Chapal Khasnabis. He is a technical officer at the Development of Violence and Injury Prevention. His responsibilities include CBR and mobility assistive devices. He is a key architect and chief editor of the CBR guideline, which is a joint publication.
Chapal Khasnabis he uses 34 years of experience to highlight the need and benefit of CBR and assistive devices. He is the editor of the joint provision paper on mobility devices. He is a representative of World Health Organization.
Chapal Khasnabis: Thank you, Chair. Thank you panelists. I will try to keep it as short as possible. Can I have my slides, please? It's not there yet.
Okay.
World Health Organization introduced the concept of community-based rehabilitation which evolved over the years. But a lot of changes have taken place since WHO introduced this concept of community-based rehabilitation. There have been epidemiological changes. The issue of polio, childhood blindness and others are diseases of the past.
Aging is blurring the divide between visible and non-visible. There are social changes of nuclear families and family to individual.
There was an economic change. There was economic growth and recession. There are changes in the disability sector with different models along with the latest Convention on the Rights of Persons with Disabilities.
A few things have not changed much. As for the World Report, people with disabilities generally have lower health, fewer economic opportunities, and a higher rate of poverty than people without disabilities.
Even today, majority of persons with disabilities are struggling to meet their basic needs. I give you some quick shots of different countries with scenarios of different disabled people.
All of these people are from the Millennium Development Goals countries. They have ratified the Convention. But the benefit is not reaching to those who need it most.
Most of these people think CBR is their only ray of hope. This lady from the slums of Nairobi told me what inclusive development means to them. Their stories are never published in a peer-reviewed journal. But these are the people making differences in people's everyday lives.
We started with the hierarchy of needs of Maslow. We are talking about basic needs, safety needs, and social needs as the primary foundation for dignity and self-actualization.
The first thing is first. Many disabled people don't have these basic needs granted. If you don't have the basic needs, forget about dignity and equal rights. That is why CBR is so relevant.
CBR is quite a common strategy in more than 95 countries, mostly in the developing world. If you see the map on the left and the right with CBR countries and MDG countries, it is almost identical.
Why are they identical? There must be some common links. If you look at the Millennium Development Goals eight goals and really try to analyze these goals, they fall into the livelihood, education, health, and social sectors. Goal 8 brings these four sectors together.
This is the foundation of the CBR matrix or guidelines where we have a 5x5 matrix. We have health, education, livelihood, social, and empowerment as our fifth component. Each component has 5 elements.
If someone says they only work in education, they need to read the education booklet. Then read the introduction of empowerment. Then you understand the value of working together.
CBR targets 4 key development sectors. We are not talking about mainstreaming everywhere. We are targeting health, education, livelihood, and the social sector. If we can make these sectors inclusive of persons with disabilities and the marginalized group, we will have success.
The empowerment of persons with disabilities and their families and communities is the foundation. This is our CBR building. We have four cornerstones with empowerment as the foundation of the building.
CBR is a comprehensive strategy. It is about reducing poverty and meeting basic needs fast and then additional needs such as habilitation, rehabilitation, skills training, etc. The most important is living in the community as others.
The whole aim of the CBR guideline is to achieve community-based inclusive development. Make everyone included.
What does that mean? Health, education, livelihood, and social are the four key sectors that should have an inclusive approach. This inclusive development benefit will not go to the rural or the poor unless we have a community-based approach. Then we can have inclusive development and then we can think of a society for all.
The CBR guidelines bring development and human rights together. In many places, people still talk about rights versus development. We need both. We cannot have just one. This is what the CBR guidelines are talking about.
We are quite familiar with the two-track strategy. We have done one step forward. We say CBR is a triple-track strategy.
One is a mainstream strategy. Most of you know what that means. We have assistive devices and things like that. The most important part is reverse mainstreaming. That is where CBR should pay more attention.
Reverse mainstreaming goes beyond business as usual. Disability programs to include others who have similar socioeconomic issues need true inclusive development. Everyone is included. If everyone is included and gets the benefit, this will ensure community participation and community ownership. That will lead to more sustainable models.
In a community, sometimes it is difficult to say who is disabled and who is not. You have old people. Their children have deserted them. There is a large family with old people. There are grandparents with a disabled child.
In a community or a village you can't just focus on one person or one family or one visible person. Try to see everyone who needs support and bring them together.
I want to give two examples of inclusive community development where everyone is included and part of development and everyone gets benefits.
I bring one example from Japan where the inclusive community development by the local community happens. This is in the Fukushima Province where we had the nuclear disaster. They have a very good CBR program.
They were in debt. People were migrating to the cities for better jobs. The villages were being deserted. But people of the village came together and started a community development initiative.
This program soon produced the desired result and started improving the local economy and the living conditions. Among the members, the community mental health specialist wanted to include everyone, especially those who need it most, persons with disabilities.
They created residential facilities for people with mental health problems and other disabilities. They included them in the program. Persons with disabilities are now integral to the whole development. That is inclusive.
I take another example from the south of India. They are reducing poverty and ensuring standard of living through self-help groups. These groups are not just the visible women. There are single mothers, windows, and other disadvantaged groups that do the activities together.
The local government dedicates 3% of their budget to the program for persons with disabilities and follow the CBR matrix. These five components is now taken care of by the local government.
In the 2014 budget, there is a 3% allocation. All programs are local and funded by local and led by local people. That's how they made changes in the community.
CBR services are available at the community level. People don't have to go to big cities. They get services at their doorstep.
But there is a bigger problem. Inadequate water sanitation and hygiene. This problem was more for women with disabilities. India has more mobile phones than toilets. This is how development goes. We forget about the basic needs.
CBR program assisted a family to build a toilet at home. 1/3 of the costs were family contributed, 1/3 CBR contributed, and 1/3 contribution from the local government. Everyone started using the toilet. People realized the benefit of it.
Now the whole village is building toilets and it is improving the health outcome and dignity of the people. These people are not invisible anymore.
Everyone in the village is now building toilets. Local government is assisting in improving wash facilities. The whole culture is changing. The health outcome is improving. It is benefiting everyone. That is community based inclusive development.
Thank you very much.
[APPLAUSE]
Stephan Tafrov: Thank you for that interesting presentation. I now give the floor to Ms. Jean Judes, who is executive director of Beit Issie Shapiro Center, Israel's leading non-profit organization in the field of disabilities.
Jean Judes has been working in the field of disabilities for 20 years, including as director of community and community social work. She holds a master's in Social Work, Planning, and Management from Bar-Ilan University. You have the floor.
Jean Judes: Thank you very much. Good afternoon, everyone. If you can look on my left-hand side, I would like you all to imagine yourselves as a four-year-old child.
You have been picked to participate in an innovative research. You are asked three simple questions about the three children in front of you. Who would you like to play with? Some kids are real smart. Which is that kid? Some kids are likely to make a mess? Which is that kid?
Now think of the children in your community. How would they answer these questions? I will come back to this.
Beit Issie Shapiro Center is Israel's leading non-profit organization for disabilities. We are committed to making an inclusive society for all. I am proud we were awarded for the most effective NGO in Israel.
We are honored to have consultative status on ECOSOC. I am delighted to talk to you about the community-based rehabilitation model and how we have implemented it into practice.
Let me tell you about our strategy for social change. Our organization is unique because we are based on a community oriented model. Every initiative for change we do touches simultaneously on three core activities: Service development, influence policy and attitudes, and the dissemination of knowledge. It usually has a national and international impact.
We innovate model services for unmet needs. We don't expand our services but transfer our knowledge through research and training to other NGOs, government, and local councils who adopt these services in their countries.
This frees us to invest in development and innovation. The only exception is a model where we developed a family support center that is culturally adaptive.
Let me go back to our services. We developed the first early intervention center. We developed the first multi sensory center. We developed the first dental clinic for people with autism. Many of our services are replicable all over the world.
Everything we do has a component of changing attitudes in the community and influencing policy and legislation necessary for an inclusive society.
One needs broad-based partnerships. We have been leading a coalition for many years. We have had significant changes in our legislation. We needed to join forces to get to far-reaching changes.
We believe that if you want to go fast, do it alone. If you want to go far, do it together.
Families and persons with disabilities are our major partners and allies in this process. While some believe that CBR is mainly service provision within the community, we at Beit Issie Shapiro Center and many of us here believe it is that and more.
We tackle CBR with our circles approach. That is based on the belief that for an inclusive society, one must look at the persons with disabilities as well as the interaction of the person within the family, the community, and the society with the policies that surround the person.
Any community based change requires us to intervene on all levels. I will bring forth an example of how we have applied this in practice. I will show how the CBR model changes the quality of life of persons with disabilities and their families.
The project was in response to parents who shared their frustration that they couldn't take their kids out to play because there were no accessible playgrounds. When they did go to playgrounds that were not suitable, they felt excluded and people distanced themselves.
We decided to build an accessible and inclusive playground that would take into consideration social accessibility that requires the removing of barriers of social stigmas.
We planted the playground in a beautiful park with many partners include persons with disabilities, their families, the community, architects, etc.
We planned a park that would be very attractive for all children with varied abilities based on universal design. We named the park Let All the Children Play. Is that not our dream behind community-based rehabilitation?
But an accessible park is not only about the children. It is also about the parents and grandparents with disabilities. A member of our local council, shown in this picture, could not go to the park as a child. She could not take her four children to the park.
But at 50 years old, she is expecting her first grandchild and she will now be able to go to the playground with her grandchild.
Remember those three questions I asked at the beginning? We wanted to check how children felt about peers with disabilities.
At a very early age, children think, feel, and act differently towards children with disabilities and have negative perceptions towards them. These perceptions are the basis for future stigmas.
We realized we had to undertake a serious educational program in the kindergartens and schools to change the attitudes of the children as well as the teachers and parents. We designed an intensive workshop for these three groups and worked on the attitudes of all these people.
But we know perceptions turn to stereotypes. In order to remove barriers and make real and deep change in society we have to change attitudes towards the whole age spectrum starting from kindergarten teachers including youth and up to adults.
I don't have time to tell you about the programs but they're very interested. You can contact me afterwards for more information.
To reinforce change we contacted Sesame Street in Israel. They added a character in a wheelchair. She's part of the community with the children on the show. We have developed workshops with our children to portray messages in the park. I will show you a short clip about this.
[Video: About Beit Issie Shapiro Park.]
[Applause.]
How did we leverage the park project to make a national impact? Today we are giving consultation to local councils in Israel to set up more of these parks.
How did we impact policy? A critical component in policy change is awareness in policy makers. Last week, as a result of this model and with the help of the commissioner of the Rights of Persons with disabilities, our government has signed regulations for all parks in Israel to be accessible. It is now mandatory by legislation.
We are now helping other countries to set up similar parks in their countries.
To end my presentation, CBR is a multi-layered and holistic approach where you have to look at the child and his needs for accessibility, the experience of the family and change legislation. We have learned together from the work in the United Nations and from our experience that there are a few principles to follow.
Identify the community needs for recreation. Remove barriers. Approach this with a rights-based approach. Families and parents have a right to be part of a community. Persons with disabilities and their families were our major allies.
After all of this investment, we are receiving different answers to the questions I asked in the beginning of the children we worked with. Imagine how much further we can go in the future. We are committed to sharing our knowledge. If you want to speak to us, we would love to learn from you.
We believe that with global partnerships and the implementation of the CRPD we can all make a difference. Let's join hands to make this difference. Thank you.
[Applause.]
Stephan Tafrov: Thank you, Jean Judes, for sharing your impressive experience of your organization and your country. We will remember these images for a long time.
I am turning to Ms. Venus Ilegan who is the Secretary General of Rehabilitation International. She was the first world chairperson of Disabled People International (DPI). Prior to that, she was the project manager of a national rehabilitation program which provided services to over 14,000 children and youths with disabilities in the Philippines.
She participated in the CBR guidelines. She has been a member of the editorial committee for the World Report and the World Bank.
You have the floor.
Venus Ilegan: Thank you. It is my distinct honor to be able to join the distinguished members of the panel. Rehabilitation and habilitation are topics close to the heart of my organization, Rehabilitation International. In the last 90 years -- nine decades -- we have been involved in rehabilitation work in various levels.
To a great extent, community-based rehabilitation is also something I truly believe in as a concept and strategy. This is a vehicle for reaching the enriched and helping persons with disabilities reach their potentials and to access services on equal basis with others in their communities.
I will have to deviate a bit from my original presentation. Listening to the presentations of those who spoke before me, I thought the things I intended to speak about are not much to the wealth of technical knowledge that has already been shared.
I decided to bring practical lessons to the table about how community-based rehabilitation and habilitation have served as vehicles to get me where I want to be.
It is not always to be speaking of one's own personal experience. But this time, I realize that the task I would have to do this afternoon is to convince you that it's worthwhile to be making an investment for the rehabilitation of persons with disabilities and that the return from the investment can be meaningful and substantial.
I was initiated in the CBR in the mid-1990s; a time when involving persons with disabilities in the program was not easily accepted. At the time, persons with disabilities were largely seen as recipients of services but seldom part of the management team or service providers themselves.
I was born and raised in the Philippines. Accessing services was almost wishful thinking when I was growing up. I live in a village visited by typhoons. The Philippines is an archipelago of 7,100 islands. We are separated by waters. Services were hard to access.
Given this kind of reality, CBR provided the only option to be able to access rehabilitation services as a stepping stone to accessing education, employment, health and other services. It was a struggle to convince CBR workers that the woman with a disability can contribute to CBR.
Attitudes changed as we went along. The professional running CBR programs realized having persons with disabilities involved in the management of CBR programs brought added value to the initiative.
Here is why. We, as persons with disabilities, can be experts on our situation. We know what we need. We have ideas on how to fulfill or realize those needs. We can be the source of simple and practical ideas that can lead to solutions.
It takes two to tango. Combine the expertise of professionals with the practical ideas and experiences of persons with disabilities and you get a good solution to many problems.
The person with a disability is pleased that he or she is able to contribute to finding a solution to his or her own challenges. The professional feels pleased about what was achieved. The families and communities at large benefit from having a member of the community who can pursue economic activities that can contribute to the development of their community.
Community-based rehabilitation was initially a service delivery strategy with a medical rehabilitation focus. It has evolved over the years and has undergone changes in the way it was practice. It was a medical-oriented approach and is now a comprehensive rights-based approach.
CBR is understood today by various stakeholders as a strategy to promote inclusion, rights and equal opportunities for persons with disabilities, especially in developing countries where resources are often limited.
Apart from vertical CBR programs, the twin track approach promotes inclusive environments. This has become an increasingly accepted strategy. In over 100 countries, CBR is similarly being used to collect data to support quality development.
Let me also tell you that there are challenges. These challenges include that CBR programs are often initiated by non-governmental associations as pilot projects. Money comes from outside of the country. Sometimes they remain pilot projects even after decades.
They are also never upscaled. They remain small projects. They are never institutionalized. Sometimes the learnings are never documented.
Another challenge is that CBR projects are often run by volunteers. In that case, when there's no more support, then the initiative that has been started becomes unsustainable.
The last example I could cite is that when the funding is lost, the quality of the service diminishes or the program dies.
What can states do? CBR has so many potentials. We need states to formulate and harmonize effective legislation, policies and programs to translate the provisions of the CBR into practice.
This translation needs to be understood in local languages for local officials and community members to have ownership.
This will also deepen the understanding of the responsibility to be inclusive of everyone.
CBR is an effective vehicle to highlight the fact that women and girls with disabilities are prone to multiple discriminations on account of their gender, poverty and disability. The need for gender perspective in all aspects of work in disability at all levels is important.
CBR facilitates communication among governments, persons with disabilities and their families, other partners and stakeholders to achieve a common and shared goal. Raise awareness. Combat stereotypes, prejudices and attitudinal barriers. CBR can advance cross-sectional research on disability issues.
Information and communication technology relates to persons with disabilities.
Article 26 on habilitation and rehabilitation emphasizes the importance of early intervention, promotion of supporting people in the community. These are strategies that can have significant payback in support people to realize their full potential.
In this way, dollars spent on rehabilitation and habilitation can ensure that people become productive citizens. This is investment with a real potential payback.
Ratification of the CRPD has brought about a global momentum for inclusive societies where everyone can play a role and make a contribution for development. Let's seize this opportunity to build a future where everyone is included with or without disabilities.
If you ask me whether it's worthwhile investing in CBR, I say it's definitely yes.
Is it expensive? If you speak of the long-term, it is not. Why do I say this? Because your governments will spend less money if you invest the resources, especially for the rehabilitation of children with disabilities at a young age when they have the most opportunity to realize their potential.
It would be more expensive for you to be spending your dollars taking care of poor, uneducated persons with disabilities. In our culture, we have the responsibility to take care of them.
I thank you.
[Applause.]
Stephan Tafrov: I'd like to thank Venus Ilegan for her passionate appeal of CBR. I remember her last point about the fact that CBR is a cost-effective approach in terms of inclusion of persons with disabilities. Thank you.
Nawaf Kabbara: Inclusion could be a little bit costly in the beginning as a capital investment. In the end, it's all benefits. I think this is the most important point to look at concerning disability.
The more we go into inclusion, the less cost in the middle and long terms. Also, we have to look carefully about the different challenges that Venus Ilegan addressed.
Let me introduce Mr. Taavi Lai. He works in the University of Estonia.
At the Ministry of Social Affairs, he has created current Estonian national healthy policies and the framework for monitoring the health system performance.
In his current position, he coordinated the development of national e-health policies and further integration of health, social care and other solutions.
He has also contributed to many groups and provided support to evidence-based policies. The floor is yours.
Taavi Lai: Thank you very much. It is an honor to be here to address this distinguished body. Let's seize the opportunity to develop inclusive societies of the future.
For me personally, a very important part of the future society are the e-solutions. I will talk about experience I have gathered in my own country.
Estonia is a very small country. We have a population of 1.3 million. On an administrative level, we have more than 200 municipalities. That is an important detail which I will come back to later.
The rights of persons with disabilities are in the forefront of our constitution in a special Equal Treatment Act. Since May 2012, we have also ratified the Convention on the Rights of Persons with Disabilities. We have been following the principles since regaining our independence in the early 1990s.
The strategic planning in Estonia in the field of persons with disabilities comes under the jurisdiction of governance function of the Ministry of Social Affairs which spans social, health, and labor sectors.
As such, this is a good example of how policies can be integrated already on a structural governmental level.
The National Health Plan that was already mentioned in my introduction has a special horizontal topic on social cohesion and equal opportunities that directly addresses people, problems, and issues relating to persons with disabilities.
An important thing in Estonian policy planning system is that all strategies need to have a measurable objectives, targets, and accountable action plans and direct linkage to financial and other resources.
On strategic planning level, there is also a development of targeted strategy on equal opportunities and social security underway.
Why I underlined the administrative division in more than 200 municipalities is that, on average, the population size in administrative units is rather small, averaging to 5,000.
As you can see on this slide, the services provided at a local level are mostly the services for community-based services. They are supported living, transportation, translation, sign language, supported dedication, and these kinds of direct services and they are the responsibility of local communities and governments.
The other services provided are mostly provided on a national level. But then again, the support for actual implementation in localities and communities needs the resources of these municipalities.
It is important to understand that the problem and this fragmentation of services and resource need is not particular to the area of persons with disabilities but spans all public service areas.
The problems in service provision come from an aging population, regional variation of disabilities, a high number of municipalities with varying capacity, and scarcity of human resources.
One of the solutions or possible tools to overcome this fragmentation integration of different levels of society from national to community was seen in Estonia and is still seen in widespread use of different e solutions, whatever they are.
We have created a national platform for integration on provision of ICT services. We have a unique national ID and digital signature.
If you think about the possibilities of these kinds of solutions, what would that mean to inclusion of people in everyday life of society? You can vote online. You can submit a tax return form online in 5-10 minutes. You can do electronic banking. You can submit electronic applications to whatever services you apply for.
The vision that all public services need an electronic front end at least is to reduce barriers. Regardless of place, disability, or some other social problem, people can at least request the services.
To support this overall vision, we have a specific strategy on an e-information society which states that everyone must have free access to the Internet, public electronic services, and accessibility of public services in the context of usability with various disabilities. They also need the education to use the services provided with this strategy.
Going more specifically into e-services that persons with disabilities could use and are using, there are two main categories. There is telecare and telecommunications.
In the case of scarcity of human resources, that enables distant consultations and distant help services. There will be distant assessment of whether a physical service is needed or not.
On a generic level, there is e-prescription development in Estonia where you can go to your GP if you want a prescription. Or you can just call a GP and the prescription can be renewed online. Then you can go into whatever pharmacy in the country and get your medication.
The important thing is that, while it doesn't seem a major thing for a person, think again. There are background services. So your insurance status is checked. Your health insurance, social insurance status is checked. You don't have to go to several offices in person.
You don't have to fill in reimbursement claims. It is seamless service integration in the background which reduces barriers for actual users.
In the case of e-prescriptions, the experience in Estonia is that 90% of the prescriptions are electronic and most people don't even remember having to use a paper prescription.
This kind of background and front-end service integration extends to social service providers for health care.
The third area in how e-services can help people with disabilities are different communities with information sharing and empowerment in general.
The underlying idea or important message here is that e-services are not things in themselves but they have to complement existing physical services. Integration of physical and electronic services is one of the key things when you think about e-services.
It is important to keep in mind that changes in organization of services can happen when you implement electronic services.
An example is of psychological assessment service. If you think of a video conference as a service provision, in a community you don't have to have a specialist. You need to have someone who takes the equipment for video conferencing to the person.
Then with scarce human resources or other scarce resources, you can use them for greater benefit and access is improved.
Another important thing in e-services is that they have to be integrated through levels of care and service providers for seamless user experience. It is all about user experience.
In summary, e-services in countries like Estonia and many others help tackle resource constraints. It changes how the services are provided and that can happen. The change needs to be thought through when you plan additional electronic services.
Integration of social services like health, economic, labor, etc., all need to be integrated into a seamless package for usability for persons for added value.
This all helps to reduce barriers. By doing that, we widen employment opportunities, productivity, and also standard of living for persons with disabilities and everyone else.
Thank you very much.
[APPLAUSE]
Nawaf Kabbara: Thank you very much. We still have around 40 minutes. I would like to open the floor for discussions. If it is possible, do not exceed 5 minutes for questions or arguments due to the time limits.
Go ahead, please.
Sierra Leone: Thank you. The Country of Sierra Leone is making efforts in the area of developing programs in community rehabilitation as part of its commitment to improve the lives of persons with disabilities in the country.
Together with our partners like Sight Savers, the country has been running a program for community-based rehabilitation in all of the regions. But like the panelist from the Philippines said, the question of funding is very critical.
Right now, the program has ground almost to a halt because funding has been kind of thin. But with the newly established Commission for Persons with Disabilities in the country, of which I am chairman and chief commissioner, we believe that the commission will do everything possible to ensure that programs of that type get funded and get continued.
We look forward to any cooperation with other people who have that experience because we need more information. We need to share information. We need to get collaboration with other people to make sure that persons with disabilities in Sierra Leone get what they need and deserve. Thank you.
Nawaf Kabbara: Thank you. Next, please?
New Zealand: Thank you very much. On behalf of New Zealand, I would like to thank you for such visionary presentations. A number of the presentations have shown that CBR has relevance in developing as well as developed countries, especially of the lives of disabled of people that need to be transformed.
New Zealand is embarking on a multi sectorial CBR approach to transform how persons with disabilities can be included in society called Enabling Good Lives. This approach has been supported by the Think Differently campaigned.
As the lady from Israel identified, changing perceptions is crucial. This will only be successful as a community development approach when we think outside the square with all involved, especially persons with disabilities at all levels of the project program.
We have been mindful of this and have ensured that the steering group, at least 50% of the people in the group, are persons with disabilities.
This project is being tried. I do note that Venus cautioned we need to move beyond trial projects. It is a trial project in Christ Church for the last 18 months but most of its infrastructure has been destroyed.
I encourage thinking of CBR as an approach in developing countries as well as developed countries. Thank you.
Nawaf Kabbara: Thank you very much.
Haiti: Thank you. I convey my special thanks especially to the panelists for their statements. Distinguished delegate, colleagues, need I remind you that the number of disabled persons after the earthquake that struck Haiti in 2010 has been significant.
Today we have specific guidelines for rehabilitation which has guided people in wheelchairs who have been struck by poverty. This is led by a program under WHO. There have been prosthetic and other care provided in the context of rehabilitation.
I would like to share that last May a group of young disabled Haitians participated in a sports camp for one week in the United States. This was organized with the Para-Olympic Committee of Haiti and the US Department.
These young athletes received sport training in tennis in wheelchairs. They played basketball or rugby in wheelchairs. They learned to swim. I am sure that some of us may have seen this on television. A few years later, some young Haitians were playing soccer.
We have various experiences in this respect. For example, integration in musical activities, craftsmanship and museum visits. In the region we have had a Caribbean high-level conference on policies inclusive of persons with disabilities. The organization of this high-level conference was proposed by our president during his participation at the most recent meeting of the heads of state.
They welcomed this suggestion. They kept this issue on the agenda so other countries can face the many challenges linked to disabilities.
There will be a follow-up meeting annually to look at progress made by each member state as regard to social inclusion of persons with disabilities.
Nawaf Kabbara: Let me draw your attention to the questions posed by us and also by the panelists concerning the challenges facing CBR; the positive and the problematic. There were also some positive actions we have to look at.
Let's be as argumentative as possible so we can learn a go forward. I remember what Venus said. Sometimes we feel like we are not advancing. We have to move forward and advance the concept.
South Africa, please.
South Africa: Thank you chairperson. My delegation and I wish to make the following additions as per your request. We are making contributions to the outcome documents for the high-level meeting. We want to make the following additions.
In the background document, when you look at the document as it stands, it creates an impression that community-based rehabilitation can help with some challenges faced by persons with disabilities. We find that as a problem. We see community-based rehabilitation as a continuum of care.
We ask that the relationship between rehabilitation and habilitation and community-based rehabilitation and habilitation be clearly spelled out in the background of the document so that the relationship is clearly spelled out. Indirectly you are not replacing one with the other.
The second thing is that we feel strongly about that particular aspect because it would then make member states also put the rehabilitation human resource strategy in place so when they put aside budgets for the training of professionals in the prospective member states they need to include budgets for other professionals.
We also feel that persons with disabilities should be put at the center. If you look at the document at the moment we support what has been said and the role of the family. But we also need to be honest that it's not every disabled person that actually enjoys the same status in their families.
To an extent, there needs to be a balance in the document to create the ability for the disabled person to stand on their own two feet, supported by the family.
When you look at the document now the family is above disabled people. We are saying the success of community-based rehabilitation lies at the center of persons with disabilities, their organizations being put at the center of it. That is where the success of community-based rehabilitation is.
We need to ensure community-based rehabilitation strategies are not piloted forever.
The document highlights that these strategies should be incorporated in the health strategies of our countries. They should also be state funded. Unless the state funds these programs they remain at the pilot stage and undocumented. But also, there are no lessons learned.
For us, it's very important that the cross-disability nature of community-based rehabilitation also be highlighted. At the moment, when you read the document it creates an impression that community-based rehabilitation is about physical disability without taking into consideration the realities of visually impaired individuals. We need the document to actually recognize the cross-disability nature of community-based rehabilitation.
It is only at that level where that aspect is strengthened that we would be able to appreciate what community-based rehabilitation is about.
Lastly, we need to also place community-based rehabilitation as an economic empowerment instrument for disabled individuals who intend to enter as health professionals. They are not only seen as volunteers.
We can be able to create a meaningful position for those who are workers so that they are accredited and that professional aspect can also be accredited and recognized. The aspect of their salaries should also be allocated within the structure of the Department of Health within our respective states.
We feel that information can go a long way in improving the document as it stands. We thank you.
Nawaf Kabbara: Thailand.
Thailand: Thank you. I agree that investment on CBR is important for communities with persons with disabilities. I think that a way for this program to be successful is to make sure the professional is a key person. The professional should work with the volunteer in the village because they know the problems in their villages.
A person with disability can train volunteers.
Monitoring and evaluation are important for the community to know what the problems are that they need to solve in the future.
620 persons with disabilities are receiving services in Thailand.
Nawaf Kabbara: Thank you. Ghana.
Ghana: Thank you.
Recognizing the danger of addressing the symptoms rather than the causes of exclusion we ask if it is sufficient to be tolerated at the table or welcomed at the table. Ghana's community comprises 20% of the population. A significant part of our overall challenge is not with the 20% but with the 80% normally able bodied whose choices and inactions impact the lives of our citizens with disabilities.
These behaviors originate from the beliefs that have negative connotations. We need to start belief-change programs. The origins are ignorance, superstitions, religious dogma and received prejudices. This may seem to be a daunting task.
We believe this is doable if we address each origin effectively. Our research unearthed an appreciated fact we would like to share. We found that 55% of all human conceptions are spontaneous. This tells us two things. Creation operates a quality control program.
There's a second fact from this. Every human alive has been endorsed by creation and approved by the maker. We are now able to pose the fundamental thesis. If your god endorses disability, on what basis do you disagree?
So far our test engagements on this issue have brought about a positive response. It now remains for us to take it to a national level. Our post-2015 development discourse in our efforts to score a rights-based quality of life for the community, we may forget to engage the hearts and minds for the other 85% with whom we seek inclusion. If we don't bring them along, are we not just preaching to the converted?
We believe the continuum of care starts with the family. When a child with a disability enters the family, more often than not they are denied.
Unless we change these fundamental beliefs and attitudes then we will continue to have an uphill struggle. A continuum of care starts with the family and goes through health, education, social acceptance and empowerment. This is much like the CBR. We have to focus first on acceptance at the family level.
In Ghana we augment our rights-based agenda with three rationales.
The moral obligation of one human to another. The social responsibility. The economic imperative that actually brings all sides together.
Thank you.
Nawaf Kabbara: Egypt.
Egypt: I would like to make our comments regarding persons with disabilities in our country. We worked in two ministries in offices to ensure rehabilitation adaptation. There are 24 offices in the ministry. In addition to a specific project for persons with disabilities, there are 37 associations of civil society which are also working on the problem.
The Council for Disabilities was created in 2012 with a committee on adaptation. I would like to underline the actions that Egypt has been taking through various bodies and with several bodies such as the association of persons with disabilities without borders and the objective of that project is to ensure people have the right to receive rehabilitation services.
And there is a strategy for adaptation based on social action.
This project is to go from 2010-2013. During that period, several working groups were established. And more than 8,000 persons with disabilities will be benefited from this project and 4,000 of their families in low-income regions.
These strategies must be global in nature. They must be based on social aspects and they must be financed by governmental and non-governmental groups. We are also counting on projects based on social action.
We are also counting on receiving the benefit of experience of others. That may not be sufficient, but there are also other obstacles we are facing. There are other challenges such as the lack of personnel, weakness of coordination among the various bodies involved.
The conclusions here have not been implemented in a comprehensive fashion. There is a lack of knowledge regarding the CBR sector and the quality of the services rendered. Egypt, through its efforts, is attempting to benefit from the experience and actions of other states in this sphere to improve the situation and have the best possible situation for persons with disabilities. Thank you.
Nawaf Kabbara: Would the panelists like to say something?
Chapal Khasnabis: I will come to the idea South Africa mentioned about the cross-disability issue. In the CBR guidelines, if you really go through the book, you will find that we have not segmented the disability sector or fragmented it.
Fragmentation will actually make us weaker. We feel the basic needs, whether you're blind, deaf, or have polio, etc., is the same. The moment you go more on impairment specific specialized need, we fragment the sector.
We understand there is a need for those, but our focus is mostly on the broader issues and how we can ensure that persons with disabilities and their families are out of poverty. How can we ensure all the disabled children can access education regardless of their disability?
That is why you will hardly find we have mentioned any particular group of disability into the CBR guidelines. We believe, in general, people have the same need whether you are disabled or non-disabled.
Referring to the comment of Ghana with 85% versus 15%. We strongly believe that this is an issue of the culture. You cannot change culture by laws.
Convention cannot do anything there. Laws and judiciaries cannot do much there. That is why our believe is community-based rehabilitation. Engage the community. Make the community aware of all of the issues. Involve the community. Work with the community.
See that the community gets the benefit. I strongly believe that nobody does anything if they don't see the benefit of it.
If you just say "I focus only on this disabled person. I don't care about the rest of the community" then it is a disaster. That means excluded disabled persons.
We have to work with this 85% and really bring them on board to include the 15%. That is the main focus on the community-based rehabilitation or reverse mainstreaming.
Make sure everyone understands and the community gets benefit as well as the disabled. We learned that the hard way, but that is the only way to change the community and the culture. It takes generations. But don't give up. We should work on it.
Nawaf Kabbara: Thank you. Venus?
Venus Ilegan: I think community-based rehabilitation is good with flexibility that includes all kinds of stakeholders. Everyone has a role to play.
Money is needed but it is not about money all the time. Community-based rehabilitation, for example, affords the opportunity for parents and children to get together. It gives opportunity for parents to just discuss about their own experiences and making them realize that they are not alone in having disabled children.
This is empowering. You don't necessarily spend money in doing that.
Also, children being able to interact with children with and without disabilities changes a lot of things. Children at a very young age understand that disability is something to be afraid of. Disability is part of human diversity. CBR affords the opportunity to do that.
There have been so many things learned over three decades of implementing CBR. We do not have to reinvent the wheel. So much has been achieved. We have to share.
I thought that having networks and working with the different networks will realize the goal of trying to make use of what has been learned to benefit us all at the maximum extent possible.
I thought that CBR will continue to be a very realistic way of reaching the un-reached, especially for those who do not have the resources.
As I said earlier, investment made for CBR means you reap the benefits in the long term. It is not something that will translate or transform things overnight. But it is really a very flexible way of attaining what needs to be done to include valued stakeholders in the community.
Of course, public-private partnerships can be used. There are too many non-governmental organization that have invested time and resources for decades to change attitudes to create a difference in the lives of persons with disabilities.
There is donor fatigue. That is a reality. We should be able to convince our communities that, while there is the goodwill to make a difference, at the end of the day, it is still the responsibility of people in the community to ensure that they are inclusive of their citizens with disabilities.
I thought that is something that is not really difficult to say. Thank you.
Nawaf Kabbara: Let them add to that. CBR is directly felt. Venus is saying it's the long term. It is not only long term.
You are getting the community directly involved in cases within its own entourage. They directly find solutions as much as they can to make the life of the person better.
Like it or not, you are going to get some positive free action directly.
Now, when we talk about much wider things then we have to talk long term and we need other stakeholders. But the community itself, when you move, it's the first acknowledgement of your existence and your right to be part of the community. At a psychological level, you are making a big difference.
El Salvador, please.
Violeta Menjivar: Thank you very much. I just wanted to briefly emphasize the importance about community-based rehabilitation. We said that it was very important to empower persons with disabilities and their participation as well as their family members.
It is important to have a rights-based approach. This is not necessarily charitable. We must focus on the importance of state support to strengthen rehabilitation that is community based.
We do need to strengthen this community participation of persons with disabilities. But that does not mean that states no longer have the responsibility to help.
States are responsible for the redistribution of income and wealth. So it cannot be to persons with disabilities alone and their community initiatives alone.
Community-based rehabilitation also involves states. States must take responsibility when it comes to allocating budget and when it comes to participation as we have seen at this important conference.
I think there must be a harmonious combination between the empowerment of the community itself but also to ensure the responsibility of states to enrich this community participation of persons with disabilities. Thank you.
Nawaf Kabbara: Absolutely. Would anyone else from the panel like to say something?
Jean Judes: Thank you, fellow panelists and people from the floor. It was interesting to hear all of your experiences.
I heard that persons with disabilities and families need a bold vision of their future. They need to be visible. We have to collaborate with mainstreaming organizations. That is what I'm leaving with. Thank you very much.
Nawaf Kabbara: Estonia, go ahead.
Taavi Lai: I will give some of my impressions and thoughts. Thailand mentioned money. Ghana mentioned belief change programs and communicative care. Egypt mentioned quality of services.
In my mind, I built a model. There is a vision. There is a passion in the community among the people. The comment from South Africa and others indicate that there is a need for a system view.
You develop a CBR but you need to place it in a context. A person from the community has a continuity of care and can go to services in different parts of the country and different levels of care.
In my presentation, I talked about electronic services and integration of all services in a systematic manner. That is important.
Then again, if we provide the services, it is important to monitor the services for quality control. That way we know what is working, what is not working, and we have an evidence base for future development.
That leads and improves our vision. Thank you.
Nawaf Kabbara: One last word from Chapal Khasnabis.
Chapal Khasnabis: I think the delegate from New Zealand made a very important observation. Is CBR just for developing countries? What is the relevance for high income countries?
There is no one model of CBR. In different countries, we see different models. CBR is flexible and dynamic.
I am from India. I live in Switzerland. My work took me more than 100 countries in the would. I am quite convinced that CBR is equally important in high income countries as much as the low income countries.
If the people from high income countries think CBR is not for us, you think about the aging issues, mental health issues, and growing population issues. You will think that CBR could be a solution for the high income countries.
CBR is knocking the door. I get a lot of requests from high income countries to learn about CBR. Think quite openly.
You don't have to copy the same model of CBR from a different country. You can develop your own model. But the basic fundamentals are the same. Persons with disabilities should be the same as others. That's all I wanted to say.
Stephan Tafrov: Thank you. It is very important to remember that CBR is for every country. There is not just one model of CBR. There are many models but the single principle matters, which you just mentioned.
We are concluding the discussion here. I think I am going to express a general feeling here in this room of gratitude to all panelists. We were very lucky with all of you with the diversity of your experiences and the depth of your knowledge and engagement with the problems of persons with disabilities.
Thank you so much. Before closing, I would like to encourage all of you to please enjoy the Other Film Festival which will begin shortly. Thank you.
[APPLAUSE]
[End of afternoon session.]
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