Regional Workshop on Comprehensive National Plan of Action on Disability - Towards the Mid-point Review of the Biwako Millennium Framework for Action towards an Inclusive, Barrier-free and Rights-based Society for Persons with Disabilities in Asia and the Pacific (BMF)
Bangkok, Thailand, 19-21 October 2005

Indonesia - Country Report

Presented by
Jonathan Maratmo
Director of the CBR Development and Training Center
Solo-Indonesia

INTRODUCTION

The development of disability issues in Indonesia to response The Biwako Millennium Framework is affected by internal and external factors. Internal factors come from the internal situation of political, economy and social progress after reformation movement in Indonesia. External factors are more affected by the development of disability issues in Asia Pacific Region which marked by The 2^nd Decade of Disabled Persons in Asia Pacific Region (2003-2012).

Reformation movement started in 1998 had changed a major political system that produced an immense social system change happened in Indonesia. That was marked by a sudden growth of democratic system that gave wider opportunity for people to get freedom of speech and expressing thoughts. Beside the growing awareness of democracy, human right issues are also becoming more prominent in Indonesia. The immense social system change above has significantly affected to disability issues. Increasing awareness of human right encourages many people with disabilities establish Disabled People Organizations (DPO) that concern to fulfill the rights of people with disabilities. In addition, Non-governmental disability organization (NGO) that is an actualization of civil organization has evolved in its numbers and activities.

In 2003 The 2^nd Decade of Disabled Persons in Asia Pacific Region was started. The Biwako Millennium Framework as key mandate and action guideline of The 2^nd Decade of Disabled Persons in Asia Pacific Region (2003-2012) had clearly described with emphasis on three main theme: inclusive, barrier- free and right based society. Around 44 countries in Asia Pacific region including Indonesia had signed the Proclamation of the Full Participation and Equality of People with Disabilities.

Internal and external factors above have affected the development of disability issues in Indonesia. As a result there is change gradually disability issues paradigm, NGOs and DPOs play big role for solving disability issues, decentralization system of rehabilitation, human right based issues for rehabilitation is also prominent, and also to respond The Biwako Millennium Framework as action guideline of The 2^nd Decade of Disabled Persons in Asia Pacific Region, Indonesia has set up A National Action Plan for Persons with Disabilities 2003-2012 (Rencana Aksi Nasional Penyandang Cacat 2003-2012).

REVIEW OF THE ACHIEVEMENTS AND SHORTCOMINGS

1. Law of Disability, Policies and Plans

Indonesia has a Law of Disability No. 4/ 1997 and some regulations related to disability issues. They regulate equalization of opportunities for persons with disabilities in all aspect of life e.g. education, employment, accessibility, rehabilitation and social welfare. Even they have weaknesses especially for the implementation and law enforcement, however the existence of the law and some regulations are greatly needed.

In focusing the implementation of Law and some related regulations, and also in responding The Biwako Millennium Framework as action guideline of The 2^nd Decade of Disabled Persons in Asia Pacific Region, The Government of Indonesia has set up A National Action Plan for Persons with Disabilities 2003-2012 (Rencana Aksi Nasional Penyandang Cacat 2003-2012). A National Action Plan consists of 7 priority of action programs is like mentioned on Biwako Millennium Framework plus International Cooperation. In each program has been described objective of program, strategy, target, schedule and organizations in charge.

A National Action Plan for Persons with Disabilities has been set up by various organizations such as: Government Organizations (GOs), Non-Governmental Organizations (NGOs), Disabled People Organizations (DPOs), Academia, and Private Sectors. Each sector should play role based on its capacity to achieve the target of National Action Plan. The CBR Center has been taking role as National NGO through Indonesian Society for the Care of Disabled Children in planning, implementing, monitoring and evaluation of action plan especially for CBR programs where CBR Center has longstanding experience, e.g. early detection and intervention, inclusive education, community awareness raising, primary rehabilitation therapy, self help group and income generating.

2. Important Values, Concept of Disability Issues

Today, many DPO and NGO have played big role to voice strongly the change of disability issues paradigm. Traditional paradigm of disability issues is not enough anymore when considering the total problems and complex needs of persons with disability in their community. Therefore a new paradigm of disability issues with comprehensive perspective is very needed for anyone who concerns with disability issues.

Traditionally disability issues are viewed as individual problems faced by individuals with disabilities. Therefore rehabilitation service is delivered as an answer to deal with disability issues. Here rehabilitation service is viewed as a medical, educational, vocational and social service that is delivered directly to individuals with disabilities. Even if it is a holistic treatment, the role of people with disability as the recipient of services is still relatively passive. The professionals are subject and decision-maker but people with disabilities are often seen to be the locus of the rehabilitation problems and are, therefore, the sole target of rehabilitation.

This perspective has gradually changed. Disability issues are not only viewed as individual problems faced by individuals with disabilities, but are more viewed as social problems faced by community. Therefore, solving disability issues need to consider the change of social behavior as a whole, rather than the change of individual with disability only. Moreover solving disability issues should be focused on comprehensive solution with more emphasis on the long-term and strategic needs of persons with disabilities. That means comprehensive efforts for struggling bargaining position of persons with disabilities in their own community that based on equal right in all aspect of life.

Now many disability organizations including government organizations are aware that they should have wider perspective of disability issues that based on human right, inclusive and barrier-free society.

3. Application of Twin Track Approach and Other Relevant Issues

Application of twin track approach is still debatable. Some disability organizations and experts agree disability issues should be integrated into mainstreaming law, policies and programs but some of them disagree due to disability issues are very specific and need specific law, policies and programs. It is understandable that in some cases we need inclusive approach, but in other cases segregation approach is still effective. Now there are disability organizations and experts working with segregation approach and others working with inclusive approach. However, we realize that we need both of those approaches.

Another relevant issues, now the GOs and NGOs and DPOs tend to combine some approaches in solving disability issues. It can be identified there are 4 approaches, namely: institutional based approach, community based approach, community oriented approach and community managed approach.

Institutional Based Approach: Where some rehabilitation professionals provide specific services for people with disabilities in facilitated institutions such as hospital, rehabilitation center, and special school, etc. Community Oriented Approach: Rehabilitation professionals’ team (Mobile Rehabilitation Unit) that come from various institutions go down to deliver services directly to individual with disabilities in sub-districs and villages. It is also called Mobile Rehabilitation Unit. Community Based Approach: This is CBR approach where some professionals from the institutions have role to facilitate community members including people with disabilities to analyze their disability problems, existing recourses, to decide appropriate action for implementing programs, monitoring and evaluation together. Community Managed Approach: Where persons with disability and community members with their own motivation organize Self Help Group in solving disability issues.

4. Situation Analysis and Planning

CBR Center has been using Participatory Rural Appraisal (PRA) as a method for situation analysis to establish CBR program, to identify people with disabilities and community needs and priorities with regard to disability issues, and to monitor and expand our existing programs. PRA is an effective method to analyze the situation and to assess the needs of services for people with disability in the community. PRA is a technique or approach, which can be used to encourage people with disability and community members to express and analyze information about their way of life and their local physical, social, economic and political environments. PRA can help community to mobilize their human and natural resources to define problems, consider previous success, evaluate local institutional capacities, and prepare a systematic plan of action. Although this approach has rapidly evolved in many locations in Indonesia and is now considered to be an effective development program implementation tools, its application to assess the needs of rehabilitation is still relatively unknown.

Based on the CBR Center experience, the benefits of using PRA method in assessing the need of rehabilitation that make it effective are that it:

• brings together the needs as defined by people with disabilities and community members with the available resources;
• creates equalization of opportunity among people with and without disabilities in the community in assessing their needs of rehabilitation services.
• provides accurate information as the information is cross-checked by local residents;
• shares knowledge and information between people with disabilities, community members and external experts thereby empowering community members;
• provides the right information when and where it is needed, as it is developed as part of the problem solving process;
• is the most economical way of gathering data.

The process of PRA empowers people with disabilities and community members so that they can develop the capacity to identify disability problems, define what is needed to solve these problems, develop priorities and a plan of action to solve them and even evaluate the actions taken.

5. Programs Implementation for Persons with Disabilities

Early Detection and Early Intervention

One of the existing resources in community is activity for serving children under five years old namely Integrated Health Post (Posyandu). Posyandu is a program managed by community members which is concerned about promoting the health of children under five years old. One village has 5 until 10 Posyandu which is managed by 5 cadres in each Posyandu. The Posyandu activities are immunization service, distributing supplementary nutrition, baby weighing and child care consultation. All of those activities are carried out once a month. Up to now the Posyandu has been a place for parents to check up on the development and growth of their children.

The CBR Center has been developing and facilitating Early Detection and Early Intervention Program at Posyandu in more than 50 villages. The aim of this program is to examine whether the child does the milestones at his/her age. Detection of childhood disabilities can be done at many levels. The CBR Center develops three level of detection. First is called screening for disability by using poster. "The Childhood Development Poster" is the basic level which most parents/ mothers can do without training or special skills. The next level of detection is called simple assessment. It happens when a child is looked at more closely by cadres in The Posyandu. The Posyandu cadres learn specific simple tasks, the test in "Early Detection of Disability in Children Under Five" manual, to check to see whether the parents’ suspicions are correct. They test to see if the child do the milestones at his/her age. If the simple assessment suggests there is a problem than the child goes on to the third level of detection, that is evaluation by a professional. This is often done by a doctor or therapist in the Community Health Center (Puskesmas). At this level, professionals try to determine the cause of the problem and predict how the child will grow.

At a large extent, Posyandu cadres are entry points of choice for implementation of early detection and early intervention. Posyandu cadres can be potential change agents for some reasons. First, as insiders they have close social relationships with members of community - they are not regarded as "stranger". Second, they are more concerned with and know problems of children under five and their families. Third, they have ability in handling problems of children under five and they have credibility in diffusion of innovation. Finally, they are able to link real need of children with disabilities with resources from outside. These change agents should act hand in hand with Community Health Center staffs, paramedics, village heads, hamlet heads, and women’s organization leaders. They need to be trained with disability early detection and early intervention.

Inclusive Education

Inclusive education is a program for providing education opportunity to disabled children by integrating them into the regular schools. Children with disabilities who are integrated into the regular schools will obtain certain counseling by teacher during the process of education. The program addresses the identified need for support in the development of integrated education program at elementary schools in rural areas that comprises four group inter-related activities: the first group activities should be done within community to strengthen every family and community to participate the programs; than the second group activities should be done in the Regular Elementary Schools as places of inclusive education program; the third activities should be done in Special Schools as resource center that provide technical assistance for regular elementary schools; the fourth group activities should be done in the Department of National Education.

The first group activities:

• Support community awareness about inclusive education
• Facilitate the establishment of Parent Association

The second group activities:

• Identifying Children with Special Needs
• Workshop for Assessing Special Needs and Planning Educational Program
• Training on Integrated Education Management and Technical
• Implementing Inclusive Education Program
• Establishing A Special Guidance Room
• Providing a Counseling on Daily Living Care for Children with Special Needs

The third group activities:

• Training for special teachers
• Providing technical assistance for special schools to become resource center

The fourth group activities:

• Making positive adjustment in government policies toward education opportunity for children with special needs.
• Developing curriculum, teaching strategy, teaching material and evaluation system that is adapted for children with special needs.

The CBR Center has been facilitating inclusive education for more than 200 elementary schools.

Community Education about Disability Issues

This program aims to increase community awareness about disability issues and to create positive attitudes toward people with disability. The activities include: illumination, provision and distribution of brochures, poster, information book and promoting awareness through focus group discussion, family simulation, family seminar, traditional entertainment, film, and drama.

Primary Rehabilitation Therapy

The CBR Center professionals train cadres/volunteers how to use simple assessment and treatment for people with disability. The families are also involved in handling their members who have disabilities in daily activities. This program focuses just on primary therapy for activity of daily living. Main activities of this program include:

• Training primary rehabilitation therapy services for CBR cadres and families
• Training how to make simple equipment by using available resources
• Providing primary rehabilitation therapy for activity of daily living
• Support surgery cost for harelip and hernia patient, contribute wheelchair and some equipment using available resources

Income Generating Program for Poverty Alleviation

The objective of income generating program is to prompt with income opportunity or to increase income of people with disability and her/his family based on their potential. The CBR Center facilitates revolving loan fund system to start small businesses and provides appropriate vocational and entrepreneurship training. By this way, hopefully the welfare of people with disability will also increase as well. Income generating program is divided into 3 phases:

Pre-Implementation:

Social approach is important to get all necessary and appropriate data and information before the program running. For that reason, PRA (Participatory Rural Appraisal) was done to analyze locally all factors related to the problems, needs, opportunities, and potencies of people with disability to get appropriate income for their life.

The Implementation:

• Providing some necessary and appropriate training such as Achievement Motivation Training, Management of Small-Scale Business, Basic Accountancy, and Creating Revolving Loan Fund Mechanism.
• For lack of capital is one of main problems faced by the people, the CBR Center provides stimulant capital of fund. For empowerment reason, the capital should be revolved in a group.
• The people should organize themselves by establishing a group and its rules. Developing mutual cooperation among the people and between the people and the community is one of the functions of the group.

Post-Implementation

• CBR Center has consultation role to the groups.
• The groups should be pro-active for wider cooperation and opportunities by developing linkage and networks with all necessary recourses.

CBR Center has been developing Income Generating program in 23 villages of 8 districts in the area of Central Java province. There were 293 persons who got direct benefits in the program as group members.

Self Help Group of Persons with Disabilities

Some establishment of Self Help Groups in Indonesia initiated by leader of disabled persons themselves and some of them facilitated by NGO and GO. The CBR Center as an NGO has been facilitating the establishment of self-help group that is a group of people with disabilities who realize that they need to develop their skills and personality as part of achieving their full potential. People with disabilities themselves make decisions and take control of their own lives. The CBR Center has been facilitating more than 10 groups of disabled persons.

In developing self-help group, the CBR Center carries out some activities:

• Providing necessary training (ToT) on leadership and management for self help group
• Facilitating a group-based self-employment
• Providing appropriate training on entrepreneurship for persons with disabilities
• Facilitating a revolving loan fund system to start small businesses
• Making a link between self-help group and outside resources.

To ensure the group would be sustained, the following attempts should be done by CBR Center:

• Training for Trainers and Consultations

Training for trainers is needed for sustaining and expanding knowledge and skills of group members in handling their programs. The training courses often take the form of individual consultations to assist with the resolution of specific problems. Selected leaders of persons with disabilities would get sufficient training to become trainers for others.

• Intervention Strategy of CBR Center

The intervention of CBR Center professionals towards the implementation and development of Self Help Group follows this strategy: First year, the CBR Center takes big role to facilitate the establishment and implementation of the group. In the second year the main role is carried out by members of the group, CBR Center is just as facilitator. Than, the third year the CBR-Center takes regular monitoring and consultation only. CBR Center would be other resource center. Finally, after project period the group would be able to mobilize their members to independently undertake their program, facilitated by trained leaders of the group.

For the first years the CBR Center, as a facilitator NGO, has dominant role in developing and organizing the group. After that the groups have being self-reliance and independent, CBR Center, as an NGO, and the self-help group as a People Organization (PO), has being mutual partners in achieving the goal of CBR. Therefore, self-help group can play big role for CBR programs, as a partner of CBR Center. The group can play its role in each step of CBR activities, from situation analysis, planning until monitoring and evaluation

6. Participation of All Stakeholders.

Growing awareness of democracy and human right encourages many people with disabilities establish Disabled People Organizations (DPOs) that concern to fulfill the rights of people with disabilities. In addition, Non-governmental Disability Organization (NGO) that is an actualization of civil organization has evolved in its numbers and activities. It implicates that the role of people with disabilities, families, local community and NGOs (civil organizations) on the efforts of solving disability issues becomes more important. For CBR Center always involves many stakeholders in its activities that are:

• People with disabilities,
• Families
• Groups of Persons with Disabilities (Disabled People Organization)

• Community members in general

• Specially trained community members (cadres/volunteers)
• Professionals
• Government
• Non Governmental Organization

All stakeholders should be involved in process of CBR activities from situation analysis, planning, implementation, monitoring and evaluation. For implementation, CBR should be based on the principles of community development, namely development of knowledge, skills and attitude of the all stakeholders toward disability issues.

7. Resource Mobilization: Human Resources, Finance, Knowledge and Technology

Indonesia Government policy for development recently focuses on decentralization system. That means the development should be based on the local needs and involved many local resources. Autonomy system gives opportunity for district to develop its region by using maximally available resources and create new resources as much as possible. The local people have more power to be involved in making decision for the regional development process.

Autonomy system has brought a change for decentralizes services characteristic. Resources and appropriate services should be available assessed as well in local areas by persons with disabilities. However, rehabilitation services in local areas are still lack of skilled human resources, financial, knowledge and technology. It is also information about the services are not easily available, especially about the services available in district areas. For that reason, it is important to establish close cooperation among local government (District level), local NGOs and local POs to develop resources and to create new resources if are not available. And also role of center government to facilitate the development of rehabilitation services for persons with disabilities in local areas must be clear. Cooperation among GO-GO, GO-NGO, NGO-NGO, GO-PO and NGO-PO in local areas as well as national level must be intensively developed.

In addition, international cooperation for development of human resources, finance and technology is a must. In National Action Plan for Persons with Disabilities (2003-2012) is also described about the importance of international cooperation, in term of purpose, strategies and target. Moreover, training is also very important for human resource development in Indonesia. Appropriate training is very needed to product qualified rehabilitation personnel with the sharp knowledge, skills and attitude. However, information about the different training opportunities is not easily available, especially about the training courses available in developing countries. It is also felt that training cost is still relatively expensive for rehabilitation practitioners who come from developing countries. For that reason, it is important to establish international cooperation for training development which emphasis on the areas of:

• Training management
• Facilitator and resource person team
• Research
• Funding

8. Monitoring and Evaluation System

To ensure the program will achieve its objectives and to know the effectiveness of the program, monitoring and evaluation are carried out regularly by using "Participatory Monitoring and Evaluation System". This system involves all of stakeholders to participate in the monitoring and evaluation process. CBR Center invites all stakeholders, such as:People with disabilities, Families, Groups of Persons with Disabilities (Disabled People Organization), Community members in general,Cadres/volunteers, Professionals and Government to take participation at the focus group discussion meeting on monitoring and evaluation. Using PRA method is also effective for monitoring and evaluation purposes.

Program monitoring is expected to evaluate and monitor the program development, including the problems faced in the fields. From the result of monitoring, recommendations would be put forwards to improve the program synergy. Monitoring would be done every three month.

Evaluation is expected to: 1) study and evaluate the agreement between the program objectives and the outputs achieved; 2) know the degree of result achievements based on the indicators already decided; 3) see the agreement between the program implementation and the plans made, in terms of process, kinds of activities, budget, and implementation (including the aspects related to inputs, processes, and outputs). Evaluation would be done annually.

9. Reporting and Public Information

In general, the report would be provided annually which cover Activity Report and Financial Report. CBR Center makes the report and submits them to all stakeholders including the Government, Sponsor/Funding Agencies, and related institutions that have cooperation with CBR Center. For public information CBR Center has plan to issue CBR News and set up a web-set.

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