Convention of Rights 27: Right to habilitation and rehabilitation

The United Nations Convention on the Rights of Persons With Disabilities (CRPD) forms the foundation of disability rights laws in Uganda and is the model for the Persons With Disabilities Act (PWDA) 2006. The CRPD underlines and recognizes that persons with disabilities (PWDs) are entitled to all the human rights enunciated in the The Universal Declaration of Human Rights. If you are a PWD the rights in the CRPD are your rights, if you do not have a disability it is your duty to uphold and promote these rights.

Article 26 of the CRPD says 1, PWDs have the right to attain their maximum physical, mental, social and vocational ability and full inclusion and participation in all aspects of life. This should be achieved through comprehensive habilitation (see below) and rehabilitation programs organized to strengthen and extend skills in areas of health, employment, education and social services so that these services and programs:

a, begin at the earliest possible stage and are based on a multidisciplinary assessment of needs and strengths.

b, support participation and inclusion in all aspects of society and community. They should be voluntary and available to PWDs as close as possible to their own communities.

2, the development of training for staff and professionals working in rehabilitation and habilitation services should be promoted. And 3, the availability, knowledge and use of assistive devices and technologies for PWDs should be promoted.

The rights discussed in this article are the rights to habilitation and rehabilitation. Habilitation is to enable, or make able it is a process that helps PWDs gain new abilities and knowledge. Generally speaking this process is for children with disabilities who have a limited amount of time to learn new skills. Rehabilitation is to restore condition, operation or capacity and refers to the the regaining of capacities lost after disabling accident or change in the condition of an existing disability (see The United Nations Convention on the Rights of Persons with Disabilities: A commentary).

The report Human Rights: Yes! offers an interesting contrast of the terms Habilitation and rehabilitation, which it says:

are often linked with health-related issues and consequently addressed along with policies related to the right to health. In reality, rehabilitation is much more complex and far-reaching. While health-related rehabilitation can be a vital aspect of strategies to achieve these goals, many other elements are equally important, including those related to employment, education, or simply life skills. To ensure that habilitation and rehabilitation are understood to include the full range of measures necessary to equip persons with disabilities to attain their goals, the CRPD addresses the subject in a separate article.

It is important to move away from the health model of disability. Disability is not a health problem to be cured. The social model of disability says: A person with impairments meets barriers, like stairs or social stigma, it is these barriers that cause disability. 

The role of habilitation and rehabilitation is to eliminate barriers as far as possible through things like knowledge, tools or equipment to enable work, education or social and community activities. Habilitation and rehabilitation are not the same as reasonable accommodation. Reasonable accommodation has the goal of making an area accessible. Habilitation and rehabilitation are about being able to move around in that area using aids. For instance, an employer is required to make a work space accessible (reasonable accommodation) but is not required to supply a wheelchair. In rehabilitation the PWD learns to move around in their wheelchair.

The 2014 National Union of Disabled Persons of Uganda (NUDIPU) report Alternative Report to the UN Committee of Experts on the Implementation of the CRPD offers the following criticism of habilitation and rehabilitation:

120. The legal framework in Uganda does not recognize habilitation as provided under the CRPD. This denies children with disabilities (CWDs) an opportunity to transit from community to school life and vice versa.

121. There is limited training of professionals in community based rehabilitation (CBR); only offered at Kyambogo University. Even the few professionals have limited government employment. Field experience indicates a general lack of awareness among PWDs and NGOs of the CBR guidelines; hence little direct participation in the programme. The cost of rehabilitation at the National and Regional Referral Hospitals, and even at private actors like CORSU, is very high for an ordinary user.

122. The CBR programme is limited to 18 out of the 112 districts of Uganda, and it relies heavily on the support of family members and does not promote independent living for PWDs. 80% of PWDs live in rural communities with limited access to water points, hospitals, firewood, shops and markets, which denies them the right to access their basic needs. This situation is harder for individuals living alone.

123. Whereas the CRPD promotes CBR as the best approach to independent living, Uganda currently promotes both CBR and institutional based rehabilitation. But rehabilitation institutions lack appropriate programmes suiting the current labour market trends.

124. MoGLSD (Ministry of Gender, Labour and Social Development) had planned providing assistive devices to about 1000 PWDs from 2008 onwards. This was insignificant compared to the 3 million PWDs who need assistive devices (Draft Rehabilitation and Health Care Policy on Disability, 2009). In some instances many who received the devices have out grown them for lack of follow up.

If you are a PWD you have a right to access rehabilitation and successfully integrate or reintegrate into society so that you can lead an independent, productive and happy life.

Children with disabilities, parents get second chance at life.
These families are part of more than 500 beneficiaries of the home-based rehabilitation approach by Centre for Disability and Rehabilitation (CDR).
The centre equips parents with occupational and nutritional skills to help their disabled children. Parents are also taught how to home school children.

This is written in Article 26 of the CRPD in the following way:

Article 26

Habilitation and rehabilitation

1. States Parties shall take effective and appropriate measures, including through peer support, to enable persons with disabilities to attain and maintain maximum independence, full physical, mental, social and vocational ability, and full inclusion and participation in all aspects of life. To that end, States Parties shall organize, strengthen and extend comprehensive habilitation and rehabilitation services and programmes, particularly in the areas of health, employment, education and social services, in such a way that these services and programmes:

(a) Begin at the earliest possible stage, and are based on the multidisciplinary assessment of individual needs and strengths;

(b) Support participation and inclusion in the community and all aspects of society, are voluntary, and are available to persons with disabilities as close as possible to their own communities, including in rural areas.

2. States Parties shall promote the development of initial and continuing training for professionals and staff working in habilitation and rehabilitation services.

3. States Parties shall promote the availability, knowledge and use of assistive devices and technologies, designed for persons with disabilities, as they relate to habilitation and rehabilitation.