World Vision Switzerland, Vietnam

Improving lives through community-based rehabilitation of disability

There are about 5.1 million people living with a disability in Vietnam, equivalent to 6.3% of the total population. Reasons for this include the legacy of war; high rates of malnutrition; an aging population and high numbers of road accidents. Most disabled people are living in rural and poor areas where they have limited access to health care services, income generation opportunities and appropriate education and social integration services.

The government’s Ordinance on Disabled Persons, issued in 1998 publicly highlighted the Vietnamese Government’s strong commitment towards supporting people living with a disability and advocating for programs, which work to support their specific needs. However, additional financial support, skills, knowledge and advocacy from non-governmental organizations is needed to compliment government programs, ensuring the lives of people living with a disability continue to improve.

World Vision Vietnam’s work in community-based rehabilitation of disability

As a humanitarian organization, which focuses on supporting children and vulnerable groups, WV Vietnam implements, as its principal strategy, Community Based Rehabilitation (CBR). CBR is a low-cost, low-tech approach to building and utilizing resources at the local level to address both the prevention of disability and the provision of rehabilitation and other services to meet the needs of people living with disabilities. The ultimate goal of CBR is to empower people living with a disability by helping them to be as self-sufficient and productive as possible.

Much of WV Vietnam’s experience in CBR has come from implementing donor grant projects. WV Vietnam works closely with local communities in developing and implementing such projects. This requires establishing effective systems for identifying and mapping children and adults living with disabilities; assessing their physical and psychological conditions; supporting access to rehabilitative services; establishing preventative practices and services; providing education and training materials; conducting training and awareness-raising events, and developing formal and informal support networks at the community level.

WV Vietnam’s CBR projects involve training and motivating local volunteers, so they have the skills and knowledge to provide advice and to support children, adults and their families with disabilities. These projects involve building the capacity of local government officials and networks, enabling them to take responsibility for the community volunteers.

Increasingly, we are trying to integrate CBR activities into our Area Development Programs (ADPs) as a cross-cutting theme. So, in addition to our special CBR projects, WV Vietnam is using the lessons learned from our experiences to improve ADP structures and services to ensure that all children and adults in WV Vietnam’s programs are effectively supported. By mainstreaming disability interventions into our ADPs, WV Vietnam will give people living with disability an even better chance to play an equal and active role in their community.

WV Switzerland supports CBR efforts in their projects in Vietnam and looks into further possibilities of sectoral projects. Below is one of World Vision Vietnam’s grant projects focusing on community-based rehabilitation.


Background

In 2001, with financial support from WV Taiwan, WV Vietnam began the Assistance to Children with Difficulty Moving (CWDM) project. The project helped CWDM to access community based rehabilitation services. Although the project only ran for a short period, it made significant progress in providing assistance to disabled children. Many of the children are now able to walk again and can attend school. Many lessons were gained from this project. However, the needs of children with difficulty moving in the central region of Vietnam is still great, hence the extension of the project. The purpose of the Assistance to Children with Difficulty Moving (Phase 2) project is to further develop and expand existing project interventions, while ensuring activities are sustainable and accessible for those most at need.

Overview of existing challenges and needs

Life is still very difficult for people living with a disability in Thang Binh District. Many are unable to access social rehabilitation and medical services. The services they cannot access include: identification, referral, surgery, physiotherapy, fitting orthotic or prosthetic devices, and both social and medical follow-up.

Due to CWDM’s limited mobility their parents have limited time to earn an income and look after other family members. As a result, the income of these families is generally very low, which in turn affects the health and living status of CWDM and plunges them deeper into poverty. In addition, many families have more than one child living with a disability. For example, in Binh Minh Commune there are three mothers sharing seven disabled children.


Project description

The project’s goal is to improve the physical, social, and emotional well being of CWDM and their participation in community life. The projects methodology is based on the community-based rehabilitation (CBR) model recommended by the World Health Organization (WHO), and works closely with CWDM, their families and existing medical, educational, vocational and social services to implement appropriate, sustainable activities. Using the CBR model allows project activities to cover three diverse areas: health, education and social, including recreational and vocational.

Project activities

  • Training is provided to local government staff and volunteers in areas including disability awareness, identification and appropriate methods on how to support people living with a disability. This training enables them to effectively plan, deliver and monitor services for children living with a disability. It also teaches them how to appropriately monitor the progress of CWDM.
  • Training is provided to health staff, volunteers and family members to provide basic physiotherapy support for CWDM in their homes and to improve their capacity to detect disabilities in babies and infants.
  • Vocational training is provided for CWDM, giving them the opportunity to learn valuable skills to support themselves.
  • Social activities, including play gatherings are organized, giving CWDM the chance to interact with other community members.
  • Mobility aids and devices such as prosthetic limbs, wheelchairs, walking frames and bicycles are provided, giving CWDM the chance to move more freely and interact with other children;
  • Government education staff receive training on how to best meet the needs of CWDM in schools.

Success story: Surgery gives hope to those in need

Diem, 12 years old, is very happy with the new bicycle he recently received from World Vision. Thanks to his improved health, he can now ride his bicycle to school, saving a lot of time and energy.

Diem was born with cerebral palsy. He does not know his father and his single mother is forced to leave him with his grandparents in a far away district, while she works in the fields. While his grandparents take good care of him, he was only capable of walking at the age of seven. When Diem started school, his grandparents had to bring him to class because he could not walk himself. However in 2002, Diem’s life was transformed thanks to the generous support from WV Vietnam’s Assistance to Children with Difficulty Moving (CWDM) project. Diem received surgery, a wheelchair and access to rehabilitation services. After many hours of rehabilitation, Diem can now walk a lot better and no longer needs his wheelchair, which he has passed on to another community member.

In September 2004, Diem had the opportunity to show off his remarkable progress, when he was invited to participate in a WV Vietnam community based rehabilitation study tour. The tour allowed Diem to interact and share his experience with other people in similar situations.

Not only is Diem now able to walk he also has the strength and ability to ride the bicycle that WV Vietnam provided. He rides it 10km from home to school everyday. Thanks to the Assistance to Children with Difficulty Moving project, Diem can now move freely and has the chance to interact and socialize with other children his age. His life has been transformed!

Project Location: Vietnam, Thang Binh and Hoa Vang Districts, Quang Nam and Danang Provinces

Period: October 2001 - September 2006

Swiss Organization: World Vision Switzerland

Website: www.worldvision.ch

Contact: Esther Bodenmann / e.bodenmann@worldvision.ch

Partner Organization: World Vision Vietnam (WVV)