Community Based Rehabilitation

A gentleman from the Ministry of Health approaches the podium at the 1st National CBR Conference in Dushanbe, Tajikistan. Six years ago we had a “friendship building experience,” in the form of a major argument over priorities for children with disabilities and where they live. Back and forth we debated: Are most in the cities or the rural areas? Do we need hospitals or community-based services, massage and electrotherapy or active rehabilitation and inclusion? I can’t remember how many times I’ve had this debate in Central Asia over the last 18 years with people who simply are stuck in an outdated system.

Then in March 2010 he and other healthcare leaders sat in my office as we faced a polio outbreak in a nearby district. He pleaded, “Please help us – we need services in the villages where the kids are, it’s too much for a centralized approach – we want to try this thing you keep talking about: Community Based Rehabilitation.

So we worked, and we worked hard. Momentum for CBR grew.
But today I hold my breath … My friend takes his place and begins talking about the last 5 years – how the country needs more Community Based Rehabilitation and more active, modern methods of physiotherapy … I release my breath… what a change!

There is still a long way to go – but THIS, this is what we work for: changed society at all levels, including government stakeholders who adjust their ideas and advocate for change in their own system. This is why it is worthwhile being here for the long run and building friendships – even through arguing.

Reaching the unreached: first national conference on community-based rehabilitation in Tajikistan