Considerations on Rehabilitation Concepts

The activities related to rehabilitation of the physically disabled people begun when social institutions, family and medicine was no longer able to provide to some specific health’s demands. Such needs appeared as a result of old fashioned concepts, such as: there was no treatment for preventing and/or recovering from impairments, and that health service only meant medical treatment. The conceptual changes, as well as practices started taking place during the international rehabilitation movement in 1940’s.

The rehabilitation of the physically disabled has always been connected to the economical model which promoted industrial development, labor rationing and scientific advancement. Meanwhile, the number of people who became physically disabled due to accidents at work, car accidents, chronic and/ or occupational diseases / disorders increased.

This economic force demanded for treatment procedures from the rehabilitation programs that could reintegrate, as well as integrate those individuals with possibilities to add to the taskforce.

In the 1940s, the rehabilitation movement started gaining some amplitude and conquered a series of specific legislative rights, changes in the social welfare systems and in the hospital and ambulatory services.

These concerns were initially diffused by non-governmental entities: World Rehabilitation Fund, International Society of Physical and Rehabilitation Medicine (creation of a new medical specialty: Physiatry), World Confederation of Physiotherapy, International Society for the Welfare of the Disabled, which is nowadays called Rehabilitation International, World Veteran’s Federation, etc.

Among the governmental entities are OIT, ONU, UNESCO, UNICEF, all of which have been welcoming and diffusing proposals and resources for developing rehabilitation programs worldwide.

The more rehabilitation and its concepts are diffused, changed and recognized, the greater are its needs on technical and financial resources; Coordinated political, social and economical actions; Joint efforts at every governmental level (Federal, State and Municipal); Society; Association for the Welfare of the Disable among others, aiming at fitting in the actual concept of rehabilitation as defined by the World Health Organization – OMS:

“Rehabilitation is a continuous process, which aims, is to reinstate the disabled to society in a way that the disabled can have the best possible physical, mental, social, economical and vocational performance, thus allowing for their social integration”.

In 1954, the IV International Labor Conference, concerned about this matter, defined Rehabilitation as a “Set of physical, mental, social, professional and economical conditions, which sole specific purpose, is to make the disabled, able to provide to their own subsistence” (Apud Carvalho, 1960:5)

Rehabilitation in Brazil

To identify the magnitude of this problem in Brazil, either in qualitative and quantitative terms, is a very difficult task due to the almost inexistence of nationwide information (data) which could, in fact, reflect the reality of the country in this domain.

The World Health Organization – OMS estimates that about 10% of the population of any country, in times of peace, have some kind of disability: 5% of which is mentally disabled; 2% is physically disabled; 1,5% have hearing impairment; 0,5% have visual impairment; and 1% have multiple disabilities. Based on these figures, it is estimated that in Brazil, over 16 million people are under these conditions.

People who suffer from physical disability resent from a variety of neurosensorial conditions which affect them in terms of mobility, body coordination or speech as a result of nervous, neuromuscular and ostheoarticular’ damages, or even of congenital or acquired mal-formation. Depending on the case, people who have locomotion problems are able to move independently themselves with the aid of prosthetics, wheelchairs or other auxiliary devices. “When these people develop some kinds of self-skills, they are able to move themselves from one place to another, manipulate objects, and be autonomous and independent”. (National Health Policy for the Disabled) – Secretary of Health Politics / Healthy Ministry)

Among the Brazilian non-profit organizations, we would like to highlight the role of ABBR - Associação Brasileira Beneficente de Reabilitação (Brazilian Beneficent Association for Rehabilitation), in the rehabilitation history of our country.

ABBR is considered to be as of Municipal, State and Federal Public Utility by the law  nº 892, passed on 14 November, 1957 and law decree nº 43.890, passed on 10 June, 1958 respectively, and recognized for all of its pioneer activities in Rehabilitation in Brazil as the National Reference Center Institution.  The institution operates solely in the State of Rio de Janeiro due to the multidisciplinary and integrality of rehabilitation treatment. Its services are provided to infants, toddlers, young adults, adults and the elderly. It is an entity of private rights, created by the joining of ideas and efforts of people who held non-profitable ends.

The 5th of August is a significant date for ABBR as well as for the Physical Rehabilitation history of both Rio de Janeiro and Brazil, for being the starting point for the implementation of a new social-medical assistance, for which there was no specialized doctors and professionals of other categories able to exercise the essential practices on this specialty.

In 05th August, 1954, the architect Fernando Lemos and the businessman Percy C. Murray congregated a group from the social elite of the state around the noble ideal to provide for the disabled people a different medical assistance, which would involve all the modalities of medical-social assistance, from physical independence to remunerated employment.

It was the beginning of a New Era in Physical & Rehabilitation Medicine in Brazil.

The first step taken towards this goal was the creation of a pioneer graduation school for Physiotherapists and Occupational Therapists which complied with the curriculum of the Rehabilitation School of the University of Columbia, in New York.

The opening day of ABBR was celebrated by the President of Brazil, Juscelino Kubistchek, in 17th September, 1957.

The Physical Rehabilitation School and the Rehabilitation Center was conceived under philanthropy inspiration and with the concourse of gratuitous doctors who, for decades and relentlessly, worked on tuition forming several new professionals and, attending patients who lacked rehabilitation.

ABBR emerged from a never inhabited desert and in 53 years welcomed more than 300 thousand patients. Today, ABBR performs about 3,700 treatment sessions a day and welcomes approximately 1,500 patients daily.

In spite of the vast services already provided for the community, ABBR, unrelentingly, continues persisting on delivering even better services to everyone who knocks on its door, and also continues fighting with courage and much devotion to the redemption of our citizens affected by mild or serious disabilities. Its magnificent sole purpose remains: REHABILITATE.

ABBR has been awarded with several Merit’s Titles and Diplomas, among of which The National Human Rights Award – 1999, granted by the Ministry of Justice and, delivered by the President of Brazil in December, 1999.

ABBR is an entity of private rights, created by the joining of ideas and efforts of people who hold non-profitable ends.
Its organizational structure and the Board of Directors are supported by:

1. General Assembly;
2. Deliberative Counselors
3. Fiscal Counselors
4. Consultant Counselors

It is also part of ABBR, a cooperative group represented by the “Senhoras da Sociedade do Rio de Janeiro” – (Ladies’ Socialite of Rio de Janeiro) to whom we refer as legionnaires.

The Non-Remunerated Counselors are notorious and unselfish people who materialize their altruistic ideas by dedicating part of their time and professional experience to ABBR.

For the process of decision-making, there is an Administrative Executive Board committed to the operational results of the institution.

ABBR is compliant to Regulatory Agencies and Unions and, keep management accounts controls which include independent auditing services.

Vision
A healthy and efficient institution that still remains pioneer in terms of Physical Rehabilitation in Brazil.

Mission
“Our wish is for those people, unable to perform to their full potential, to be able to experience happiness in living and contributing to society”.

Values

• Make its services available to anyone who needs them, whether they have financial resources or not, independently of philosophical-politics, ethnic or credo. ABBR does not discriminate.
• Operate professionally and transparently.
• Respect Human Rights and honor the National Human Rights Award, granted by the Ministry of Justice and delivered by the President of Brazil in December, 1999.
• Value its employees and donors.
• Value all of its diplomas, certifications and prizes awarded.
  

In order to achieve its objectives, ABBR provides qualified and efficient services to children, young adults, adults and the elderly.

5.1 REHABILITATION CENTER

The Rehabilitation Center has several treatments’ resources as well as a team of qualified multi-professionals who have earned their graduation at renowned institutions and universities.

The board of specialized doctors treats several different pathologies: brain trauma, stroke, spinal cord injuries, myelomeningocele, tetred cord, amputations, impaired neuromotor development, congenital malformations, rheumatic diseases, Parkinson disease, multiple sclerosis, amytropic lateral sclerosis, etc.

The Rehabilitation Center has the following specialty’ professionals:
Physiatrists; Orthopedists; Rheumatologists; Sports Medicine Physicians; Occupational Therapists; Phonoaudiologists; Psychologists; Pedagogues; Music Therapists; Social Workers; Physiotherapists; Physiotherapists Assistants; Occupation Therapists Assistants.

ABBR’s Rehabilitation Units:

• Physical Therapy
• Occupational Therapy
• Music therapy
• Speech therapy
• Psychotherapy
• Social Services

5.2       HOSPITAL

The hospital is designated to two main purposes – rehabilitation and surgery. The first one is designed for heavily injured in-patients with the objective of providing a set of intensive and productive rehabilitation, aiming at fast and efficient recovery; the infirmaries are destined to SUS’ patients (SUS – National Health Service).

The Surgery Unit is designed to in-patients for surgeries related to motor and orthopedic traumatology and reconstructive plastic surgery; it comprises of large rooms, sterile material and X-Ray. It has a semi-intensive Unit for post-surgery recovery and medical emergencies.

The in-patients’ surgery unit comprises of bedrooms adapted to patient’s individual needs and it is also comprises of supportive methods for diagnosis with X-rays, laboratory and cerebral palsy – impaired neuromotor development.

The professionals available on a daily-basis for the in-patients are: nutritionist, physiotherapist, psychologist and social service.

This unit is responsible for manufacturing and offering prosthetics and orthotics for ABBR’s in and out patients whose prescriptions were assigned by ABBR’s members and non-members doctors. It also offers customized orthopedic shoes, wheelchairs and other auxiliary devices.

Orthotics – Devices used for preventing, and correcting malformation and /or to improve the mobility of some parts of the body.
Prosthetics – Device used for replacing some organs and /or a part of the body.

ABBR has been performing its activities, implementing new routines, improving the quality of services, repairing and fixing its premises, acquiring material and equipment thanks to financial donations received from all over the world.

ABBR is sustained by two distinctive areas:

* Resources Funding: responsible for the institutions’ relationship with government entities and companies.

* Operational Funding: responsible for the relationship with health insurance companies and privately held services.

ABBR is a non-profit organization. At least sixty percent of the services offered are destined to low income people (those who can not afford private services or health insurance plans). The financial resources received by the government and private health insurance companies are designed to pay staff’s salaries, utility bills and medications.

The financial donation received is solely destined to the maintenance of activities and improvement of the premises.  Financial statements are publicized and affixed on the information boards throughout the institution.

Each gift has the power to support the rehabilitation of thousands of disabled people. We invite you to consider the following ways to support us:

Cash donation (for general support, purchase of wheelchairs, orthopedic shoes, etc.)
Securities and Properties
Planned gifts
Donation of equipments and medical supplies

We can also develop a proposal for specific projects, such as remodeling a treatment unit in need of repairing and improvement. In this case, we will develop a project according to your budget and will provide all the receipts and financial statements.

At ABBR, our social responsibility is seen as a commitment from the institution for the society. We demonstrate, transparently, our performance by making public our activities. ABBR is now going through a restructuring process, improving even more, the quality of its services to the elderly, infants, toddlers, young adults and adults.

We rely on you…

In case you want to come visit us or contact us, we will be delighted to meet you!!!

E-mail: administracao@abbr.org.br
Address: Rua Jardim Botânico, 660 – Bairro Jardim Botânico – Rio de Janeiro / RJ
CEP: 22461-000 – Brazil
Website: www.abbr.org.br
Phone Numbers: (011) (55) (21) 3528-6363 / Fax: 2274-6942


Maio/08