Hi Julie
As a person from another developing country that is India, I agree with the
sentiments you have expressed. However in my country, community based
rehabilitation has not made much headway. I would therefore tend to agree
with the suggestion that equal representation of individuals with
disabilities has to be there in the decision making processes. There are
times when I am totally baffled when I realise that even if intentions are
there , the resources are just not available. So even though I will not
really support institutionalisation, more so their quality is always
problematic, I am quite unsure of what the appropriate solution can be. The
socio-political and economic reality of developing countries is to be
considered, before any models can be imported.
Anita
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| From: Julie Livingston <[log in to unmask]>
| To: UK Disability-Research <[log in to unmask]>
| Subject: Re: Dogmatic ravings:Blackmail by Institution Supporters
| Date: Sunday, June 20, 1999 1:36 PM
|
| Hi-
|
| i just wanted to add my two cents onthis topic. While I agree with the
| general argument put forth below -- I do want to break down what we mean
| by institutions somewhat. Again we are talking aboutthe "developing
| world" here -- which is, inmy limited experience in Africa, quite
| lacking in institutional structures which help the disabled. I would
| argue that the few institutions which are in existence are an important
| part of the overarching "community service" program and that in fact we
| do need more of them.
|
| I work in a "community based rehabilitation program" in Botswana --
| which is the cornerstone of the national policy on disability and
| assistance. But our CBR program which operates in 8 villages is linked
| to a rehabilitation center -- yes an institution-- which has
| physiotherapy, speech therapy /sign language instruction, and
| occupational therapy services, and mainatains a residential program for
| disabled children. It is however, quite different from a residential
| program in a developed country. There is no chance at all here for any
| person to be completely institutionalized -- I am not saying that the
| ideas are so forward thinking but there simply aren't hte resources, and
| I wouldhave to guess that there won't be any time in the forseeable
| future.
|
| Instead, in my experience, residence in this instiution, is one of the
| greatest possible pushes for independence and progress for teh disabled
| in Botswana, becuase teh children are taught skills which their families
| had often assumed them incapable of.
|
| When a child coems home from a year or two (the maximum possible time)
| at teh center, able to feed, bathe, and dress themselves, for the first
| time, or able to communicate in more sophisticated ways then before, or
| able to write their name, or help weed the garden, it can change their
| position within their family and their opportunitites for the future, it
| is often teh first step towards "independent living" though of course it
| must be followed up by better community services. When we are simply
| working with our clients through CBR there are many cases in which the
| teaching of these basic skills is extremely difficult or even
| impossible, whether becuase of over protective family members who see
| their relative as a "patient" and so fee obligated to do everything for
| them, or simply because families are too overburdened with daily life,
| which can be quite exhausting here (farming, carrying water, colelcting
| firewood) , to take on anything they see as extra.
|
| Likewise with disabled adults who enter teh Red Cross rehabilitation
| center where tehy live for up to two years learning a trade, it is often
| teh first time in this largely rural environment where they meet and
| interact with other disabled adults, increasing their social and
| political consciousness. or with teh center for the blind which is the
| only place in the country to learn braile, or to train for possible
| employment. There is a long waiting list to get a spot in any of the
| centers in teh country.
|
| I am not suggesting that these institutions and programs are without
| problems, in fact they strike me as riddled with problems, but I am
| saying that they are not necessarily bad, nor are they exactly the same
| as teh institutions in the west. And more importantly neither is the
| context.
|
| We cannot wholly export our institutional models or our culture of
| giving, and likewise we cannot simply export our critiques to another
| political, economic, social, cultural environment without a nuanced
| understanding of that other place.
|
| i would advocate that what is necesary is not merely a shift away from
| institutions but a policy of inclusion of local disabled people
| themselves in the planning and critique of such programs, institutions,
| and policies. I would imagine that one of the best ways for teh
| disbaled community in the west to help that in a place like Botswana
| would be to foster some sort of dialogue between teh two and to help
| develop the nascent political rumblings of the very quiet voice of the
| disabled here.
|
| it is not simply that we don't need institutions and only need community
| based programs -- here as I see it we need both, but they need to be
| coordinated and conceived with community based services as their
| organizing principle.
|
| Perhaps the situation is quite different in other "developing"
| countries, at present i can only speak for teh situation as I see it in
| Botswana.
|
| I'd be interested in other opinions,
|
| best,
|
| Julie
|
| Julie Livingston
| National Institute of Research
| University of Botswana
| P Bag 00708
| Gaborone, Botswana
|
|
|
|
| -----Original Message-----
| From: Frank Hall-Bentick <[log in to unmask]>
| To: [log in to unmask] <[log in to unmask]>; OZAdvocacy
| <[log in to unmask]>; OZMad <[log in to unmask]>;
| UK Disability-Research <[log in to unmask]>; USDisabled
| List <[log in to unmask]>
| Date: Sunday, June 20, 1999 3:32 AM
| Subject: Re: Dogmatic ravings:Blackmail by Institution Supporters
|
|
| The following is an article on Supporters for Institutions. The funding
| of
| Institutions is a global problem in both North and South Countries. It
| seems
| that it's easier to get funds for disability services through
| Institutions
| as this provides the funders and politians which the bricks and motar on
| which to stick the plaque of recognition.
|
| Community services aren't as grand as buildings.
|
| We need to ensure that we don't export these outmoded Institutions to
| developing countries, so we must share our independent living models
| with
| our disabled brothers and sisters in these countries. We need to
| increase
| our influence on our politicians, bureaucrats and Non-government
| organisations who provide funds to overseas disability projects and
| services
| that they fund local community services and not intitutional bricks and
| mortar.
|
| This is an ongoing battle in which we must all speak out against
| Institutions in favour of local Community Services.
|
| Frank HB
| Australia
|
| "PatrickWm. Connally" wrote:
|
| > Dogmatic ravings: Blackmail by Institution Supporters-The Neo
| Stalinists
| > are up to their tricks
| >
| > Please follow the logic of the neo Stalinists in their propaganda war
| to
| > label people neo Reganites who support closing institutions for
| people
| > with disabilities.
| >
| > The Neo Stalinists argument runs like this: There is the huge chunk of
| > money that can be spent on institutions. If you are not for spending
| on
| > institutions then you are for abandoning vulnerable people on the
| street
| > just like Ronald Regan did when he was Governor. Regan's policy was
| to
| > close institutions and not provide community services. He literally
| > dumped people from the mental health institution out on the street.
| > (Many were immediately institutionalized in the criminal justice
| system
| > at increased cost to everyone.) Therefore if you want to close
| > institutions you want to dump people on the street. Pro Institution
| > people ask "Where are they suppose to go?" Never asked is where did
| > people come from and how do we get them back.
| >
| > So these compassionate people are saying that the only thing money can
| > be spent on is institutions. Billions of public dollars are available
| > for institutions with their building and ongoing support, so much
| money
| > that we could buy the institutionalized population a condo with a room
| > for a live-in attendant, pay the live-in attendant and visiting
| nurses
| > and leave more than $30+ a month in spending money the
| institutionalized
| > disabled person receives from their monthly SSI check. (Most of the
| > benefit check the institution keeps for board and care.)
| >
| > Academic studies and media exposi's from Willow Brook scandal of over
| > twenty years ago until today have shown that people get better
| services,
| > better protection, and a better quality of life with resources spent
| in
| > the community. Yet the pro institution people tell us public money
| can
| > only be spent on institutions?
| >
| > This is blackmail. The idea that you either go along with
| institutions
| > for people with disabilities or you get nothing!
| >
| > Why are policy makes suddenly buying into "the state will take care of
| > you." Especially after they saved us from "communist or socialized
| > medicine." Us who receive the brunt of disability policy know the
| state
| > can facilitate its "choice." What choice do people have when beds in
| a
| > government institution need to be filled and justified. What choice
| is
| > there when there is no money for attendant wages and benefits yet
| > hundreds of millions for institutions?
| >
| > Do we make it easy to fill institutional beds or do we make it easy
| for
| > people to stay in their homes with their families and communities. Do
| > we tell our children, that at a point in the life cycle when you
| become
| > too disabled, you will be uprooted and shut away. What do we tell
| them
| > of life and their culture when we say, "A lot of those places are bad
| > and I hated to do it but it was the only choice I had. It seemed like
| > there were nice people there."
| >
| > Laguna Honda the public institution in San Francisco, California is
| > tenure for a professional and managerial class along with job
| security
| > for the maintenance staff and groundskeepers. It is a fundraiser and
| an
| > artificial ghetto environment. It is an investment in a show piece
| and
| > not dealing with the real issues of disability policy like
| > transportation, housing, employment, adaptive equipment, and
| > healthcare. The money spent on the bond would buy a whale of
| community
| > services, but the Neo Stalinist have framed the issue as their way or
| no
| > way.
| >
| > Policy makers can always get by with saying "look at Laguna Honda, see
| > all the money we are spending." The community based hands on workers
| in
| > California's Developmental Disabilities System have been hearing this
| > for years and are paid poorly. Institutional workers in the system
| are
| > paid better. What a great system for everyone if community programs
| > were reimbursed comparable to institutions.
| >
| > I guess people think the poor house model of service delivery was a
| > success in Victorian England.
|
|
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