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Good morning all,

Just for your consideration, I would like to offer a definition of an
'institution' that makes more sense to me than the one normally implied:
"an institution is an establishment that is run for the benefit of the
staff".

On that basis Julie many of the 'institutions' you refer to would avoid
the stigma.

happy monday, rgds John

Julie Livingston wrote:
> 
> 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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