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Rehabilitation by Palestinian NGOs
submitted by This Week In Palestine

Rehabilitation: a story of transformation and change

By Ghada A. Harami

When Kareem is able to enrol in his village school with his siblings and peers, we are hopeful. When Leila is able to participate in her family activities and be active within the community, we are proud. When Samar is able to join the university, have access to all its resources, and ultimately equally compete for a job to start her career, we are on the way to democratic practice. When Kawthar is married and proudly starts a family like other young women in her village, we are optimistic.

Kareem, Leila, Samar, and Kawthar are four Palestinian citizens of different ages who have various disabilities; all are struggling hard to be included in family, community, society at large, and, equally important, in the systems and structures of the society and the PNA in Palestine. Within the obvious struggle of Palestinians, there is the struggle of a group of people who seek inclusion. The four youngsters, just like 3 percent of the population who have disabilities, have been marginalised and stigmatised by society for many years. These youngsters know what exclusion means and struggle for their rights within society. They also know well how the attitudes and practices of society can be disabling, thus creating a more severe situation than what their own physical, mental, or sensory disability creates. The four youngsters have also come to understand, like their peers, that medical care, services, and therapies are, by and large, insufficient. Their needs go beyond ensuring that the organs of their bodies function adequately; their deeper need is for basic rights that include the societal values, attitudes and beliefs that provide the democratic space for them to live equally as citizens and enjoy the opportunities and resources around them just like everyone else.

Within this context, a large network of Palestinian non-governmental organisations (PNGOs) - our partners - have struggled over the past fifteen years to highlight this social approach to rehabilitation. At this time in Palestinian history and political struggle, these organisations have bravely taken upon themselves the responsibility of dealing with the problems faced by people with disabilities. Whereas some organisations are specialised in service provision offered by professionals in rehabilitation, these pioneering PNGOs transformed service provision through a modernised approach of empowerment and liberated themselves from the old traditional approach of long-term care and shelter-style rehabilitation. Their goal in service provision has been the ultimate social integration of their clients through supporting them to be reintegrated into their respective contexts and environments as soon as possible following rehabilitation in institutions. Their remarkable strategy in this has been the demystification of the rehabilitation process, the empowerment of their patients and their families with knowledge, and the democratic practice of access to services.

Other partners, a broad network of committed organisations, complement the comprehensive approach with community work, a strength that forms an integral part of our history and traditions as a people. In the absence of a state and of a centralised information system, our partners initiated a close cooperation with the local university to research the problem and identify the underlying social causes of disability as well as the effects and implications. Joint community work has started with local communities to raise awareness, promote positive attitudes, strive for inclusion, and lobby and advocate for the rights of this group. Family-based interventions, which involve mothers and families, comprise support to the child/adult to identify problems, set priorities, and take problem-solving initiatives in order to reach independence and assume control over their lives. In addition, a community-level intervention targets the community at large and its structures. The work includes awareness-raising, prevention, integration rights, education rights, and a basic rights approach to equal community membership and utilisation of public resources. Access to political, social, cultural, and economic rights is the goal, with full inclusion as the vision.

The full participation of the target group in this process, the disabled people themselves, is the guiding principle. The Community Based Rehabilitation (CBR) programme believes strongly in working with, not for, disabled people and therefore the groups that have been organised by the target group themselves have been a main component of the strategy in order to achieve a democratic future and sustainable development.

Increased interest is now apparent in the village councils and municipalities (some of which already include disabled members who have been elected to leadership positions) to locally manage the programme at the community level. The NGOs who have run the programme in the past are now generously handing over responsibility to these local government structures because of their belief that further decentralisation will provide sustainability and a broader-based ownership and commitment on the part of local communities to alleviating the problems associated with disability.

CBR in Palestine is implemented in partnership with the Swedish organisation Diakonia and the Norwegian Association of Disabled (NAD) and today works together with 266 local communities in the West Bank and Gaza and in four refugee camps in Jordan and Lebanon. The committed development support from Sida (Swedish International Development Cooperation Agency) and Norad (Norwegian Agency for Development Co-operation) and their long-term partnership, which is crucial to achieving such change, has been a contributing factor in the promotion of CBR work and success. Several evaluations have been conducted and, most remarkably, an impact study, a gender study, and a user-satisfaction study have been published.

It is our aspiration that the four youngsters mentioned above, and their peers in similar situations, will see the day when their struggle in society comes to an end and when they can enjoy the exercise of their human rights and the protection of the law. It is our vision that these youngsters will experience having full control of their own lives. Palestine is in need of the efforts of every single member of its society and its structures. Palestine is proud to set the example of an inclusive democratic society for the region one day.

Ghada A. Harami is the deputy regional director of the Diakonia Middle East Office in Jerusalem and the programme manager of the rehabilitation programme jointly implemented by Diakonia and the Norwegian Association of Disabled (NAD). She is a Palestinian and can be reached at ghada_diakonia@palnet.com. For more information about Diakonia, visit http://www.diakonia.se/middleeast.

TWIP September 2009

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