Introduction

Community rehabilitation in the developed world is in its infancy. However, the less developed world (the South in modern terminology) has been using community-based rehabilitation services for at least 20 years. The purpose of this chapter is to describe community rehabilitation practice in the South and to explore whether any lessons can be learnt from that accumulated experience that can be put into place and developed in the North.

Epidemiology

Rehabilitation services are virtually nonexistent in many parts of the South despite huge, and increasing, numbers of disabled people. Estimates of disability amongst the global population have varied widely according to methods of survey and definitions of disability. However, the generally accepted figure (see Chapter 2) is around 10–14% of the total population. Many of these people have relatively mild disabilities and resources worldwide have tended to concentrate on those with more severe disabilities. The OPCS survey in the UK estimated that about 2–3% of the total population had a disability sufficiently severe to warrant the help from another individual at least once in every 24 hours (Martin et al., 1988). A significant proportion of moderately and severely disabled people are elderly and as life expectancy is less in the South it could be expected that the prevalence of more severe disability is also less. However, this demographic statistic has to be balanced against the higher rates of disability resulting from perinatal problems and communicable diseases.