International Centre for the Advancement of Community Based Rehabilitation (ICACBR)
Description and History
Queen's University is recognized as a major player in the wider international community's commitment to the full citizenship of persons with disabilities. This has been achieved through its involvement in global collaborative research, educational initiatives and policy development that strengthen the quality and scope of health and social services for and with persons with disabilities. Queen's based organizations and departments involved in this development process has included primarily the International Centre for the Advancement of Community Based Rehabilitation (ICACBR) and the School of Rehabilitation Therapy as well as faculty from Policy Studies, Psychology, Engineering and Education. ICACBR was established at Queen's University in May 1991 as one of six Centres of Excellence funded by the Canadian International Development Agency (CIDA) with a mandate to advance the development of community based rehabilitation (CBR) internationally. Closely affiliated with the School of Rehabilitation Therapy, the Centre draws from the vast resources offered by the University, Kingston and Canadian community. It is comprised of a network of clinicians, researchers, educators, persons with disabilities, and policy analysts. Mutual respect, cultural understanding and creativity are key to its success. Its work is focused on transferring skills, building local expertise, and creating an environment for persons with disabilities to engage in the development of sustainable, integrated and accessible health/social services. The aim is to maximize community participation and citizenship of persons with disabilities and minimize the inappropriate use of resources.
Queen's has spearheaded a number of international CBR and disability initiatives in over 15 countries in the Asia Pacific Region, Central and South America, Central and Eastern Europe (CEE) and Africa including countries in conflict, post-conflict and democratic transition. Queen's has worked extensively with local governments, education/research institutions (universities, colleges and training institutions), NGOs and consumer organizations and international agencies such as WHO/PAHO, ILO, UNDP, ESCAP, World Bank, DPI, CARE, and Handicap International (HI). Queen's has also been Canada's implementing agency in a tripartite international CBR program with Israel in Guatemala and with Japan in Repulika Srpska, Bosnia-Herzegovina (BiH).
Since the mid-80s Queen's has contributed to the reorientation of health and social sector towards community based approaches to the delivery of rehabilitation and disability services. Areas of activity include curriculum development, education and training of rehabilitation practitioners, community workers and persons with disabilities, the development of appropriate technology, research, strategic planning, design and management of CBR services. Central to its work is building partnerships between educators, professionals and persons with disabilities that is empowering for all. A few examples of Queen's activities internationally are as follows.
In Russia, the first program of occupational therapy for nurses at Volgograd Medical College and Moscow Medical College was established and curriculum on OT to Department of Psychology at Moscow State Social University (MSSU) was introduced. Over 15 nurses graduate annually from the OT college program and over 200 students at MSSU complete a course on OT as a part of the education. Persons with disabilities teach the core course on disability issues in the college and lecture at MSSU.
ICACBR has developed extensive experience working with vulnerable populations in the development of CBR as a viable strategy for the provision of needed rehabilitation services in areas of conflict and post-conflict including BiH and Kosova, with victims of landmines in the Balkans and Central America and refugees in the camps of Macedonia and Albania. It was a major player in the post-war health and social reconstruction strategies in the Balkans working closely with the World Bank and the WHO. ICACBR was the lead technical agency in the World Bank/ Federation of BiH War Victims Rehabilitation Project that created a national network of over 40 accessible CBR centres as the core of this country's national rehabilitation system (1996 to 2001). It contributed to the introduction of independent living programs, peer counseling and the strengthening of the NGO sector to advocate for progressive disability policies and social justice for all persons with disabilities including victims of landmines. Extensive training was provided for over 500 health and rehabilitation practitioners on current approaches to community practice, environmental awareness and management, the development and training of a network of 50 persons with disabilities trained in peer counselling and small business development and legislation focussed on a community approach to rehabilitation. Queen's, in partnership with HI, was instrumental in establishing the first Physical Therapy School at the University of Prishtina, Kosova (2000-2004) and the education of 100 CBR workers employed by a HANDIKOS, a local disability NGO to facilitate the integration of persons with disabilities into community life (1999-2001).
Over 50 primary health workers and 20 persons with disabilities in rural Guatemala were trained as CBR workers to make accessible, for the first time, basic rehabilitation for persons with disabilities living in isolated areas (1999-2001). This program has been incorporated into the municipal rural primary health system of Nebaj. Low level mobility devices were designed by graduate student engineers and occupational therapists working with Indian women in Kingston and a rural community in India so that women with disabilities who have no use of their legs could be independently mobile in their home and community (1996-1997). This technology has been translated into different languages and shared internationally to communities faced with similar physical and environmental challenges.
Over 50 research activities and 200 publications and presentations have been conducted by Queen's personnel (1993-2001). Areas of interest have included women with disabilities, attitudes, beliefs and behaviours towards disability, the role of NGOs in developing programs for persons with disabilities, CBR evaluation, and the critical dimensions and conceptualization of CBR. It has shared this knowledge and experience internationally to gain a better understanding of the core dimensions of CBR and the strategies for effecting social change. Lessons learned are guiding Queen's and other agencies in the further development and refining of development programs and curriculum in CBR and disability. At least 15 graduate students from China, Brazil, India, Japan, United States and other countries have completed Master's training in CBR and rehabilitation science in the School of Rehabilitation Therapy. Over 100 internationals have conducted lectures in which thousands of Queen's students have benefited from their knowledge and experience over the years.
Over 50 Canadians have conducted graduate level research nationally and internationally in CBR and 10 undergraduate student have completed placements in international settings (1992-2001). Queen's has participated in the advancement of Canadian foreign policy as well as working with WHO and ESCAP as consultants and advisors for the classification of disability, setting priority directions for the development of CBR, assistance to landmine victims, peace building and children's rights. Further, Queen's has recently established a formal partnership with a First Nations and Inuit groups in northern Ontario to work with government and local services to develop a CBR worker program. This has been a direct result of its international experience.
The outcome of extensive Canadian and international experience in the field of disability and rehabilitation services reform has been a heightened national and international profile and significant return on investment in international initiatives. Queen's is recognized as a university with a strong focus on internationalization and the education of professionals in international development in the field of CBR. Queen's has enhanced its capacity to inform students, faculty, managers and policy makers on the opportunities, challenges and accomplishments of other countries in the advancement of disability and rehabilitation programs and policies. Over 200 Queen's faculty, professionals for the Kingston and Canadian rehabilitation and disability community have participated in these activities. Working internationally has resulted in Queen's expanding and diversifying its portfolio of education and research including the establishment of CBR in the undergraduate curriculum for rehabilitation students, as a Masters and PhD program offered by the School of Rehabilitation Therapy. ICACBR has also developed curriculum on international development and disability for High Schools in the Kingston region. Of particular note, Queen's is more effective in managing and designing more technically relevant/responsive international development programs and conducting a more strategic approach to meeting the needs of a diverse set of stakeholders with demonstrable results. Unquestionably, the ability to function effectively and credibly as an international implementing agency active in all sectors - service, education, research and policy - has been made possible by the access to the diverse resources and network that a university setting offers its international partners.