Perceiving disability and practising Community-Based Rehabilitation.
This thesis explores two distinct yet inter-related issues within the twin fields of disability and
developments tudies. First, the evolution of Community-BasedR ehabilitation( CBR) as the
"received orthodoxy" for disability service provision throughout the developing world. Second,
the developmenot f two theoretical" models"o r perspectiveso f disability: the medicala nds ocial
perspectivesT. he assumptionws hichu nderpinC BR haven ot generallyb eens ubjectedto critical
examinationn or hasc onsiderationb eeng iven ast o how CBR andt he theoreticalu nderstandings
of disabilityi nter-relate. This thesisc ritically analysesth is inter-relationship.
The thesisd escribesa ndc ritiquest he theoreticalu nderstandingosf disability,a ndt he philosophy
ando perationapl racticeo f CBR, beforec onsideringh ow eacho f thesec anm utuallye nhancea nd
developt he other.T his analysiss uggestws aysf orwardt o developinga na lternativeu nderstanding
of disability, which is pertinent to the experience of disabled people in a developing country
context. It is argued that neither perspective provides an intellectually satisfying analysis. CBR
has invariably been perceived by planners and policy makers in a somewhat utopian manner. A
field study of four NGO-managed CBR programmes in South India provides an empirical
exploration of these issues. The case studies enlighten and contextualise the issues this thesis
It is concludedt hat a universal" model" of disabilityi s inadequateb ut that insightsc an be drawn
from both the medical and social perspectives. Importantly, an "improved" understandingo f
disabilitym ust take into accountt he way in which the experienceo f disabilitya nd impairmenti s
shapedb y economic,s ociala ndc ultural factors.T he thesisa lsoc oncludesth at althought here are
problems inherent in the principles and practice of CBR, it has the potential to create an
unprecedented opportunity for disabled people to improve their well-being. Given that
"empowerment"i s becomein creasinglyim portantw ithin CBR. there is potential in considering
the implications of Paulo Freire's philosophy of social transformation for operational practice.