Title:
|
A cultural approach to community based rehabilitation and it's implications for physiotherapy practice : a Jamaican case study
|
This study explores how health beliefs and socio-cultural factors impact on the practice
and delivery of Community Based Rehabilitation (CBR) and examines the implications
for the theory and practice of physiotherapy.
The World Health Organisation has promoted CBR for disabled people in developing
countries (WHO, 1981) as an alternative to institutionalised rehabilitation. This study
examines the practice of CBR in post-colonial Jamaica.
The researcher, a trained physiotherapist who qualified in Jamaica and then worked in the
UK conducted ethnographic fieldwork with eight rural families who took part in the 3D
Projects programme in Jamaica. She spent a year participating in the life experiences of
these participants, observing and conducting contextual interviews.
Set against the legacy of imperialism, Jamaica presents the challenge of economic
hardship, unemployment, crime and violence and class divide. However, it also offers
community resistance and this thesis explores the experiences of families living within
rural communities who are caring for children with disability. The study looks at CBR
and analyses the role of women and their families caring for children with disability and
the implications of community capacity building and the notion of community. Some of
the tensions that exist between western ideologies of disability and traditional Jamaican
explanations for the causation of disability and then the implications for care are
explored. The key role of the Community Rehabilitation Workers (CRW) was
recognised.
It is suggested that CBR should take into account the cultural and social context of the
client, the family and the community. The implications call for the physiotherapist is the
need to develop skills of networking, management and negotiation, in order to facilitate
the optimal function of the disabled child, the child's family and community.
In conclusion, the researcher suggests that there is no one single model of CBR.
Physiotherapists are increasingly working in countries other than their own
(Noorderhaven, 200 I) and as such, there is a need to develop models of practice which
reflect cultural sensitivity in the assessment, planning, implementation and evaluation
necessary for the practice of physiotherapy in a CBR programme within a post-colonial
society.
|