Polio-affected Manjunath, in his early thirties, is from Attibele, Bangalore. Partially blind Shashikumar, in his early twenties, and Nirmala, a teenager with an obvious mouth-and-jaw deformity belong to Chamarajanagar in rural Karnataka. All of them have one thing in common.
They are all beneficiaries of the Community Based Rehabilitation (CBR) or Outreach Programme in their locality. CBR is a strategy initiated by the World Health Organisation (WHO), promoting inclusive development and ensuring that all marginalised and excluded groups are included in the process. CBR creates opportunities for people with disabilities to have access to health, education, livelihood, social and economic empowerment, and ensures the holistic development of individuals within the community.
Spearheading the CBR projects in Attibele, Chamarajanagar, is a 20-year old Bangalore-based, disability and development organisation, Mobility India (MI). MI is committed to ensuring that people with disabilities have equal rights and a good quality of life, particularly those who are poor, living in rural areas and urban slums. Its activities focus on rights to health care including rehabilitation services, education, livelihood, social inclusion and participation, training and research and development.
Thanks to MI’s intervention, Manjunath, Shashikumar and Nirmala have transformed their lives. Today, Manjunath is an active member of the local Self Help Group (SHG) and champions the cause of people with disabilities in his community; Shashikumar is an SHG Secretary and a lobbyist for the disabled of his village; and Nirmala, after undergoing a corrective facial surgery, has overcome her timidity, makes a living by deseeding tamarind and is all set to go for vocational training in computing or floral arrangement.
MI launched the CBR programme in urban slums of Bangalore in 1999. Over the years, it has extended its activities to the rural and peri-urban settings of Karnataka, namely Chamarajanagar (covers 225 villages), Attibele and Jigani. So far, MI’s CBR Programme has reached out to well over 6,000 disabled persons.
MI’s long-term training courses, launched in 2002, deal with prosthetic and orthotic technologies, rehabilitation therapy and are available at the degree, diploma and certificate levels. They are affiliated to or recognised by respectable institutions. Over the past 12 years, MI has trained well over 300 rehabilitation professionals from 21 countries. It is estimated that more than 2.54 million persons with disabilities have received their services.
MI’s short-term courses comprise the ‘Wheelchair Service Delivery (Basic Level) Training Course’ and the ‘CBR Workers and Managers Orientation Courses’. The first course is based on the Wheelchair Service Training Package (WSTP) developed by WHO in partnership with the USAID. In order to strengthen wheelchair provision and improve wheelchair delivery systems, WHO evolved the Guidelines on the Provision of Manual Wheelchairs in Less Resourced Settings.
WSTP is based on these guidelines and seeks to increase the capacity of personnel working in wheelchair service delivery at the basic and intermediate levels. MI plans to introduce a more advanced level course, meant for wheelchair service managers, from this year. The ‘CBR Workers’ and Managers’ Orientation Courses’ are based on WHO’s CBR Guidelines which provide practical suggestions on how to develop or strengthen CBR programmes.
MI’s rehabilitation services, which include prosthetic, orthotic and therapy services, are made available to anyone who needs them and are tailored to suit individual lifestyles and affordability. MI also assesses the physical needs, abilities and lifestyles of individuals who require wheelchairs and arranges appropriately modified units for them besides giving training to the caretakers as well as the wheelchair users.
Further, MI also runs unique services – an accessible mobile service and workshop. The Accessible Mobile Service comprises two vans, modified and made accessible to wheelchair users and fitted with manual foldable ramps. These vans provide freedom for a person confined to wheelchair to travel in comfort with bare minimum distress. MI’s Mobile Workshop takes rehabilitation services to remote areas. The vehicle is equipped with tools, portable machines, materials and a generator. Thanks to this facility, mobility aids and appliances can be assembled and repaired at the doorsteps of disabled people.
MI also operates a unit that produces a modified version of the ‘Jaipur Foot’, a popular brand of prosthetic foot affordable by the common man. The unique feature of the Jaipur Foot Production Unit (JFPU) is that it is managed solely by trained women with disabilities. JFPU products are in demand not only in India but also in other developing countries.
Some of the recent R&D activities completed or in progress at MI pertain to an alternative wooden ankle block with a layered structure for the Jaipur Foot; an affordable, good quality, stainless steel knee joint with added features of 130 degrees of knee flexion angle compared to 100 degrees of the regular version; and revised designs of trans-tibial metal modular components.