A continuing saga of helping others across borders

Dr. Padmani Mendis talks to Anne Abayasekara about her specialty, community-based rehabilitation of disabled people

“A `Rights-based strategy’ is a phrase I heard for the first time in relation to disabled people, when I met Dr. Padmani Mendis, Advisor on Disability Issues and champion of Community-Based Rehabilitation.
“Disabled people are entitled to the same rights as other citizens in the way of education, job opportunities, participation in the life of the community, accessibility to public places and so on. Our aim is to empower disabled people and encourage them to claim their rights.”

Dr. Mendis who in her capacity of WHO Consultant, has circled the globe, is presently focused on the South East Asian region and Africa.

Padmani: Role model for younger generations

When the word `disabled’ crops up, we automatically think of people who have lost their mobility, but it covers disabilities of all kinds, like those due to mental retardation, or deafness, or blindness, or even the ravages caused by a disease such as leprosy.

A qualified Clinical Physiotherapist who has worked in the UK, Denmark and Sri Lanka, Padmani has travelled a long way since she underwent her training at Birmingham’s Royal Orthopaedic Hospital as a nurse and physiotherapist for five years from 1958 to 1962. “I loved it there,” she says A Silver Medallist in the final exam in Orthopaedic Nursing, she was admitted to Membership of the Chartered Society of Physiotherapists, UK. On her return to Sri Lanka, she concentrated on working in her chosen field.

She went back to England for a further stint of study – this time to follow a two-year course at Guys Hospital and the North London Polytechnic which led to her obtaining her Diploma as a Teacher of Physiotherapy Back in Sri Lanka, she taught at the School of Physiotherapy.

At a WHO meeting held in Indonesia in 1978, she met Dr. Einar Helander, Head of the Disability Unit at WHO Headquarters in Geneva and, although she did not know it then, it was a meeting that would change her life. It came as a happy surprise when she received an invitation from Dr. Helander in 1979, to come to Geneva as a short-term consultant (STC) and to join in the work of formulating a strategy whereby the rehabilitation of disabled people would move from institutional care to care given by the family and the community.

Together with Dr. Helander and another Consultant, Ms. Gunnel Nelson, Padmani co-authored the WHO Manual entitled “Training in the Community for People with Disabilities”, a manual that would serve as a tool for the implementation of their vision of what is now known worldwide as “Community-Based Rehabilitation” (CBR). This manual has now been translated into over 60 languages and is being used in more than 100 countries.

“It has to be repeatedly revised, paying attention to the socio-culture of each country and establishing a rapport with people wherever you go. It’s a learning experience all the time and you have to be innovative. We build on the existing resources, using what is already there.”

Over the next seven years, Dr. Helander, Ms. Nelson and Padmani then bent their energies to introduce CBR to selected member states in Asia, Africa and South America for the purpose of a field trial. In the process, Padmini went on assignments to an almost unbelievable number of countries , too many to enumerate here.

Besides enlarging the scope of her work as a STC for WHO, other UN Agencies and several international NGOs requested her services in the disability field, which meant more trips to far places.
For instance, she went to the West Bank to plan CBR for Palestinian refugees. Her work took her to China several times and I asked her about that. She felt very fortunate in having had the opportunity to see some parts of that vast country.

In July 1986 she went on a WHO/WPRO-sponsored trip to plan the setting-up of two CBR projects and in October of the same year she conducted a `”National Workshop on Disability” at the Sun Yat Sen University of Medical Sciences in Guanzhou.

She also spent a month there, planning and preparing a project document for a Rehabilitation Programme that would cover five provinces in North-West China. In September 1998 Padmini was in Beijing representing the International Leprosy Union at the 5th World Congress on Leprosy, as a panelist on CBR.

At all sessions in China, there were Chinese interpreters to translate for speakers who made their presentations in English.

Her own country, of course, wasn’t forgotten and Padmani carried out many WHO-inspired CBR projects here. She told me that when she returned from Geneva in 1979, it occurred to her that community participation was very much a part of the Sarvodaya philosophy and strategy, so she went to her friend, former Girl Guide Commissioner, Mrs. Sita Rajasooriya, who was then with the Sarvodaya Movement.

Mrs. Rajasooriya was a ready convert to the concept of CBR and she lost no time in introducing CBR to Sarvodaya workers. I find that from 1999 to 2010, Padmini has been involved in so many disability-related projects that space permits only a brief mention of them.

She has conducted workshops and training courses for UNICEF in different areas of the conflict-affected North and East; she helped to draft a project proposal for the Ranaviru Seva Authority Sri Lanka;. she acted as Co-Consultant for UNICEF to review ‘Inclusive Education in the Context of Child-Friendly Schools” and for the Swedish Save the Children Sri Lanka, in 2004 she did a “Review of Disability Aspects in the Current Tsunami Response and Recommendations for Future Action.”
She conducted an ILO-sponsored Workshop and Factory Visits concerned with including Disability issues in the Factory Improvement Programme; she was facilitator at a Workshop on “Inclusion and Access” organized by the Christoffel Blindenmission (CBM) in Sri Lanka; For the NGO Fridsro Sri Lanka, in Kandy, she was the resource person and facilitator in training pre-school teachers to promote inclusive Early Childhood and Development Centres.

With the support of Uppsala University and SIDA, (Swedish International Development Authority), Padmani set up a “Disability Studies Unit” at the Faculty of Medicine of Kelaniya University, the first of its kind in a developing country.

It was launched in 1993 under an agreement between Kelaniya and Uppsala Universities.
Padmini was its Course Director for the first five years, during which period 4 International Courses in CBR were conducted, reaching 84 participants from 30 countries. At the same time, over 15 courses were conducted for around 400 Sri Lankan professionals in the health, education, social services and NGO sectors in over 100 administrative divisions.

In 1990, Padmini was awarded Doctor of Medicine (M.D.) Honoris Causa by Uppsala University in recognition of her “Pioneering role and contribution to the global development of Community-Based Rehabilitation (CBR).”

I asked her whether CBR had caught on here and her response was that it’s amazing how willing communities in our country are, to help, “We would start by calling a meeting at which we explained the whole concept of CBR, giving out simple leaflets in Sinhala and Tamil, that further clarified the strategy. We let the community nominate someone to be trained in the right approach and that worked out well.
“Families no longer felt helpless regarding disabled children. I work closely with Fridsro in Kandy, which has Swedish connections and I’d like to tell you a true story. Over the years, people of the area have come to trust this NGO as one they can rely on.

“Fridsro received an urgent call one day from a certain village, asking for someone to come over at once to help a disabled young man who talked of committing suicide. They found a frightened family with young children, their father having been left permanently paralysed from a fall off a tree, He saw no point in living since he was a burden to his family and his wife would be unable to go out to work because she would have to look after him. He suffered from bedsores as well.

“The first thing the Fridsro field worker did was to talk with the man in order to assess his needs. He then set the ball rolling to provide necessary help. The local community health worker took the patient to the MOH for treatment for his bed sores. The Social Services Dept. gave him a wheelchair.

“Then his hut had to be rebuilt, so the NGO provided the raw materials and the community chipped in to build a new house for the family. Naturally, it followed that the man needed a livelihood and he himself came up with the suggestion that since he lived by the main road, he could run a small boutique.
”Again, the community and Fridsro came to his aid and he felt he had a new lease of life –so much so that as his little venture prospered, he wanted to reach out to other disabled people. He has started a self-help group for others in a similar situation to his own.”

In this year 2011, Padmani is still going strong. She is due to leave shortly on an assignment in Zambia. “This work gives me so much fulfilment!” she told me. I marvel at her devotion to her vocation over four decades. I also wonder how many others there may be like Padmani in our land, people who work devotedly in their own fields, not seeking the limelight.

To my mind, Padmani epitomizes the kind of person we should be holding up as role-models for the younger generation. May her tribe increase.

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