Community Based Rehabilation Project, Okhaldhunga

The Community Based Rehabilitation (CBR) project began in 2020 and is the very first CBR project to be implemented in Okhaldhunga District. Its goal to facilitate a disability-inclusive society where people with disabilities and their families experience fullness of live through their full inclusion, participation and contribution. Since 2020 we have been working in 2 out of the 8 municipalities of Okhaldhunga District, and are now making plans to work in a further two municipalities from 2025.

CBR Matrix

The project uses the CBR Matrix as a framework for working alongside the communities. It comprises 5 components of society: Health, Education, Livelihoods, Social and Empowerment. These are familiar to many other community development projects, but the difference in CBR focuses on reducing and removing barriers faced by people with disabilities, specifically attitudinal, organisational, environmental and communication barriers, within these components. Attitudes are generally negative towards people with disability in Nepal. They are considered at best people who cannot contribute anything to society, and at worst, cursed by the ‘gods’ and to be ignored.

The Five Sectors of CBR Matrix

1. Health
The health component of our work is strong, not least because we are in the privileged position of working under Okhaldhunga Community Hospital (OCH). For example, CBR physiotherapists visit people needing physical rehabilitation in their homes and teach the community how to provide basic therapy. People are referred to OCH for needs such as a medical check-ups; to help them get a Government disability identity card; for custom-made chairs, and for physiotherapy rehabilitation.

Here is an example of a chair made by our maintenance department for Pramila Nepali from Molung with a debilitating muscular condition. The chair helps her sit up to eat and interact with her family. The picture on the right is of Chabi Kala Khatri receiving physiotherapy rehabilitation at OCH.

2. Education
Under the education component, we help children with disabilities to access school where possible, and help children of people with disabilities to get scholarships. We work together with the schools to help them build disability friendly buildings, and also help those children who cannot reach school to learn at home.

This is Sajina Ghimire who has cerebral palsy, taking part in her class at school.

3. Social
An important part of anyone’s rehabilitation is to become able to take part in social activities. Under the social component, we work with the community to celebrate World Disability Day, organise picnics, empower child clubs, and encourage participation in religious and social events of the community.

Premi with spinal cord injury and her family, taking part in Christmas Day programme, 2023.

4. Livelihood
The livelihood component of this project is essential – not only to help provide income for a family but also to give a person a sense of purpose in life. There are many examples in our CBR project of families which are now flourishing, having received skill-training in a particular trade and who are now running successful small businesses.

Sunita Tamang (above) has made a great recovery from a severe stroke. With the help of her family and a one-off donation from CBR to start a poultry business, she is now able to pay back the loans from her medical treatment.

5. Empowerment
Everything we do is a step towards full empowerment of the individual and the community, but one significant step is helping the community set up disability committees in each ward of both municipalities (17 in our working current area). This year, two central disability committees have been registered as Organisations of People with Disability (OPD). They now play a key role in coordinating with the local government to address issues of disability without the CBR project’s support – a major achievement for our project and bringing much hope that this work will continue long into the future.

Above is the OPD of Molung Municipality, registered in December 2023.

Looking to the future

We are now working on a proposal which will enable us to work in another two municipalities in Okhaldhunga from 2025. We have learned much in these last 4 years and, with this experience, we hope to be able to continue this vital work across the whole of this district so that we realise the vision that Okhaldhunga is a disability-inclusive society where people with disabilities and their families experience fullness of life through their full inclusion, participation and contribution.