Towards the Realisation of the Ideal cbr; Context and Reality in Low per-Capita Income Rural Area of Flores Island, Indonesia

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raduate School of Development Studies

Towards the Realisation of the Ideal CBR;

Context and Reality in Low per-Capita Income Rural Area

of Flores Island, Indonesia

A Research Paper by:

Vivian Andyka


In partial fulfilment of the requirements for obtaining the degree of



Population, Poverty and Social Development


Members of the Examining Committee:

Dr. John Cameron

Prof. Ben White

The Hague, The Netherlands
12 October 2009


This document represents part of the author’s study programme while at the Institute of Social Studies. The views stated therein are those of the author and not necessarily those of the Institute.

Research papers are not made available for circulation outside of the Institute.


Postal address: Institute of Social Studies

P.O. Box 29776
2502 LT The Hague
The Netherlands

Location: Kortenaerkade 12

2518 AX The Hague
The Netherlands

Telephone: +31 70 426 0460

Fax: +31 70 426 0799


Contents ii

Abstract iv

Acknowledgement v

List of Tables vii

List of Figures and Maps ix

List of Acronyms: xii

About the use of the term Mediator xii

Chapter 1 Introduction 1

1.1 Research Question and Objective 1

1.2 Setting up the scene for the research 2

Stichting Liliane Foundation 2

Sample Population 3

Geographical setting 4

Statistical Data on the Disability Profile in Indonesia 4

Demographic data on Flores Island of Indonesia 6

1.3 Research Methodology 7

Negotiating and Defining terms used in this Research 7

Tools for Data Collection and Information Chain 10

1.4 The Structure of Presentation 11

Chapter 2 The Global Debate and Conceptual Development in the Advocacy of CBR 12

2.1 Community-based Rehabilitation ‘versus’ Institutional-based Rehabilitation 12

2.2 Institutional-based Rehabilitation as ‘Referral Center’? 15

2.3 The challenge of practical and ideal CBR; CBR as a concept and a practice 16

Chapter 3 The Pattern of Rehabilitation Support in Low per-capita Income Rural Area of Flores Island of Indonesia 23

3.1 The Initial Data Set 23

3.2 The Pattern of IBR – OR – CBR Services 27

3.3 The IBR institution – characteristics of the people it serves 28

3.4 The OR/IBR institutions – characteristics of the people they serve 32

Chapter 4 The Reasons of Organisation in Offering IBR or OR 41

4.1 The possible reasons why organisation A offers only IBR 41

4.2 The possible reasons for organisation B & C not having a higher proportion of OR 46

Chapter 5 Towards the Realisation of the ideal CBR 50

5.1 Bringing together the challenges of moving from IBR to OR in practice 50

5.2 OR as a necessary but insufficient condition for ‘real’ CBR? 53

5.3 Constraints on the quantities and forms of resources available for an ‘ideal’ CBR approach in disability focused agencies 57

5.4 The fundamentally differing institutional approach needed for CBR 58

Chapter 6 Conclusion and Recommendation 59

Chapter 7 References: 62

Appendix 1 – Form and Questionaire 65

Appendix 2 – Action Research Methodology 71

Appendix 3 – Design of Follow up Workshop 79


Two main rehabilitation strategies, known as Institutional Based Rehabilitation (IBR) and Community Based Rehabilitation (CBR), are reviewed in this research paper as they have been perceived as two dichotomous strategies. The primary data gathered in this research shows the significant contribution of this third rehabilitation strategy in terms of moving the spectrum towards more community based rehabilitation.

This research looks into the pattern of rehabilitation support provided by non-governmental agencies for children with disabilities in rural low per-capita income area. There are also findings which provide insights into what are the constraints faced by the organisation providing rehabilitation services. Acknowledging these constraints provides a possibility to meet the challenges and a better way forwards towards the realisation of ideal CBR.


children, disability, impairment, rehabilitation, social inclusion, Community-based Rehabilitation, Institution-based Rehabilitation, Outreach Rehabilitation, community development


The best and most beautiful things in the world

cannot be seen or even touched.

They must be felt with the heart.

(Helen Adams Keller)

This research paper has been written with the support of many people.

Many of you, I could not see or meet during this process. Yet, continuously you provide me support through encouragement and prayer. My beloved mum, my sister Clara, my brother Arbi, my Aso Ika and my nephew Adley, thank you for your motivating words and distance supports. Every phone call and internet conversation that we had during my stay in NL has provided extra energy to get through some ups and downs and take me to this final stage of my study.

A special gratitude to John Cameron for all the supports he has provided me beyond his role of my thesis supervisor. Without his mentoring and patience, I would probably not able to make it. Thank you John, for allowing me to cry when I needed to cry and for not allowing me to give up so easily. Also, for helping me in ‘breaking down’ this major piece into a workable little pieces of writing.

I also thank Ben White for his advice and support throughout the process, including the time where I ‘disappear’ and unable to write, but especially during the designing and finalisation stage. The first step and the last step are mostly the toughest ones to go through. Thank you pak for your critical point of view and input and for allowing me to knock on your office door and seek some tips and advice when needed.

Another person I want to express sincere gratitude is the convenor of PPSD, Loes Keyser. Thank you Loes for your tremendous support during the time I found most difficult to see any light in my life and my study.

To both Sharmini and Katherine, thank you for your openness and support beyond student – administrator relationship. I am glad I get to learn from your life and your value too.

If this acknowledgement part is possible for one page, I would reduce the font and make sure I get to mention everyone at ISS whom I get to meet on regular basis and whom I get to receive smile even on a grey winter day. Martin Blok – the incredible student backbone, Eef van Os, ‘mama’ Cynthia Recto, Cisca of WGD, Susan Spaa, Tanya Kingdon, Lubna, Lidwien, Mila and all the library people, Sylvia Cattermole, also Sharmein, Kalid and Mr. Woitejk of the front desk and everyone in the Friday choir of ISS who I sing with only when I came out from my hiding place and yet keep up with my ‘false tune’ voice. And several others whom I know by face and never get the chance to ask their names. Thank you, thank you, thank you…

I would like to thank NESO Indonesia for the financial support of my study. And special thanks to Monique Soesman and mbak Siska for their support and care.

I sincerely thank the director of Liliane Foundation for being very positive about my research project since the initial stage up to this moment. Also to the team in the office in s’Hertogenbosch including Cobi, Bernard, Miels and Rudy who helped out in different ways. And the team in Indonesia office in Malang, Sr. Thres and Br. Fenan for helping me in different stages of this research. A special thanks to Florie, the Asia Regional manager for being a very good partner in debating and discussing the thought and findings of this research and for our dinner ‘chika-chika’.

My ‘ganks’ with whom I have shared some unforgetful good and best moments with. Endang, Santi, Kiki (Rezki) , Joy, Umbu (Raya), Nebil, Irene, Richa, Diana, Marivic, Anna, Carolina, Lacey, Ellona, and Juan Carlos, thank you for offering me such a beautiful friendship. Also to the energetic gank of activists: Jasper, Joanna, Paula, Hiromi, and several other friends, thank you for sharing me the fire of your idealism and your passion for change. I wouldn’t want to miss this chance to also thank my group F friends. F for friendship, fun, family, and forever.

I would like also to acknowledge cici Carolien Tan from Keluarga Katolik Den Haag for her support during my study and stay. Also ci Jongke, Peter and Lanny. Ci Rethy and Ratna. And of course all friends from the choir of KKI Den Haag. Terimakasih atas dukungan dan doanya dan atas suasana kekeluargaan di KKI Den Haag.

My close friends Conny Habraken, thank you for our dinner or lunch conversations from heart to heart. Michelle, Erik and Dewi, terimakasih ya karena saya rasa ada keluarga sendiri juga di Belanda setiap kita berjumpa. Juga terimakasih buat temanku Dorine and her family dan Misja Bonke.

To Barbara and Louk de la Riva Box, thank you for your personal positive remarks and especially for your sincere care.

There are several lecturers whom I also would like to thank to. Amongst them are Helen Hintjens, Howard Nicholas, Jan Pronk, Bridget o’Laughlin, Kristin Komives, Des Gasper, and Kees Biekart and Georgina Gomez. In your special way you continuously make me believe in my ability.

A lot more I would like to express my gratitude to, including Geert, Johan, Miriam, Tjipke, and many more whom in their ways also give me moral support.

To Mama and Papa Velema, I would like to sincerely thank you for your continous support. Thijs, thank you for sharing me your thesis writing’s experiences which encourage me to stay positive about the whole process.

Finally, the person who put up with me throughout the whole process and never gave up on motivating, supporting and helping me out whenever I feel burned out with the stress of this research. Thank you Hedde. Your supports are felt in my heart. Terimakasih en dank je wel sayang.

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