| 4. In which ways is the initiative creative and innovative?
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Orientation and mobility strategies for blind people are divided into 3 steps
1. Preparation: Tak Bai hospital arranges 4 lecturers and a volunteer who is responsible for coordinating the project, and all of them from Ratchasuda collage got the training how to teach blind people on orientation and mobility. The hospital will prepare equipment for workshop, advertising CD, and vinyl banners. Moreover the hospital also makes a curriculum which is applied from community context. A period of the curriculum is 10 days. In the first five days, the content is about theory, and for the rest of the five days, the content is about practical parts. The total period is 10 days or 80 hours. The hospital prepares a performance calendar and then let authorities, who work in Organization of Local Administration, Community hospital, Tombon health Promoting hospital and work as a village headman, religious leaders, and village health volunteers in the 13 districts of Narathiwat province know about the performance calendar at the Community hospitals or District Public Health office. The authorities or volunteers try to find blind people and tell them about the orientation and mobility project.
2. Performance: all participants will follow the strategy or plans in each area, and the 5 instructors will teach outside and take a Tak Bai hospital vehicle with a local driver to a learning area for ten days. Public health officers and instructors will teach blind people together. In addition, Organization of Local Administration authorities will take blind people and their relatives to a learning place for a period of 10 days, and a religion leader and a village headman will help local people understand the orientation and mobility project correctly. Consequently, the local people have a more positive attitude and can rely on the government. In the same way, the performance of Tak Bai hospital is more efficient, authorities will feel safe while they are working in the area of unsettled.
3. Following and Assessment: public health volunteers and authorities follow and assess the result of orientation and mobility skills when blind people go home and spend their daily life with their families and communities. The volunteers and authorities will assess them by using the line program technology after blind people finish learning after 2 weeks, a month, 3 months, and 6 months. If there are blind people who do not pass the criterion of assessment, the authorities will train them again.
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| 5. Who implemented the initiative and what is the size of the population affected by this initiative?
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There are 5 stakeholders involved in rehabilitation of blind people on orientation and mobility project in the unsettled situation, Narathiwat
1. Organization of Social Development and Human Security provides information about blind rosters of all districts in Narathiwat province and address details in order to facilitate to find blind people in the community.
2. Organization of Local Administration provides vehicles to transfer blind people and their relatives to the learning places. It also sets the learning places and a canteen for blind people and their relatives.
3. Community hospital authorities, Tombon Health Promoting hospital authorities, District Health Officers, Public Health volunteers, and instructors register blind people in the blind roster and assessment.
4. In Narathiwat, there are two religions, Buddhism and Islam, and blind people and local people misunderstand and have negative attitudes to the orientation and mobility project, so religion leaders and village headmen can help blind people correctly understand the project.
5. Five lectures will provide instruction on orientation and mobility skills for blind people, and public health authorities will provide the media to facilitate them at the learning place for a period of 10 days and in daily life with their families and communities.
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| 6. How was the strategy implemented and what resources were mobilized?
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Due to the unsettled situation in southernmost Thailand, the rehabilitation of the blind on the orientation and mobility should be designed for smoothly working. For the unity of work, the resources for the initiative were as following.
1) Human resources consisted of 4 trainers, 1 project responsible man for training the blind on orientation and mobility, health officers from Community hospitals, Primary care hospitals, Public Health office, Sub-district Administrative Office, Community Leaders, Religious Leaders who are responsible for target searching and managing the O&M service for the blind, educating and guiding the good attitude about the training to the blind and their relatives.
2) Materials consisted of a white staff, devices in everyday life such as glasses, toothpaste, drinking water bottles, wallets, bills, and other necessary things in their community, vehicles for trainers and the blind.
3) Equipment/Methods consisted of a curriculum for the rehabilitation of the blind on the orientation and mobility in which the training period is 10 days. The curriculum is composed of orientation skills, journeys following leaders, self-protection skills, walking by a white staff, up and down stairs, getting on a public bus, cross the road, barrier crossing, bill checking, sense perception, smelling, listening, daily life skills, manners, evaluation and work planning.
4) Budget The National Health Security Office 12 Songkhla supported budget for officers training on the orientation skill and mobility training 10%, the staff and equipment in ADL skill training 30%, allowance for trainers, meals and drinks 30%, Evaluation cost 10% and others 20%.
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| 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
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From 2555 to 2557 B.E., the target was 198 blind men from 13 districts were trained in the rehabilitation of the blind on the orientation and mobility according to the blind needs in the unsettled situation in Narathiwat province. The most successful output was that the journey time was reduced from 1 hour to 20 minutes, the journey cost was reduced and the training time was reduced from 20 days to 10 days. If 100% of the blind are 158 blind people from 4 districts who were trained in past 3 years, 90% of blind people could attend the community activities, religious activities, do the daily activities by themselves, 57% of blind people could do their own work such as do the garden, do the hand-made broom, cooking, do housework. 100% of blind people were satisfied with this training.
The expected output of this training is the blind can walk outside of the house by the white staff to other places such as markets, attend the community activities such as wedding ceremony. The important thing is the blind can go to pray at the mosques or temples by themselves more than 3 times per week. The unexpected result after this training is the blind self-care network and the rehabilitation officer for the blind in Narathiwat province was conducted. Both networks supported the service for the survival skill training for the blind in the community and remote areas. The number of the blind who was attended the training was increased respectively. This training service and the mentioned networks distributed the services gain opportunities for the blind. This is a free of charge service. All above, the officers had provided very good services for the blind to release their suffering in the unsettled situation.
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| 8. What were the most successful outputs and why was the initiative effective?
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The community participation for rehabilitation of the blind on the orientation and mobility in the unsettled situation in Narathiwat province was started from 2555 to 2557. The team monitored the activities step by step in order to resolve the problem for the smooth working of the next steps. The activities which were monitored by the related team were the training design and work plan, during training, result summarization, evaluation, the community network meeting, problems and obstacles. There are 2 systems for activities evaluation: 1) An evaluation form for the orientation and mobility (O&M) skill efficiency after training which is composed of 4 parts of questions, the score is variation from 0-4 points, the total score is 100 points. If the score is lower than 50 points, the blind have to re-attend the training. 2) Line program follow up (group O&M). The officers of the districts will summarize the evaluation score and submit it to the trainers of the Takbai hospital via the Line program. The trainers of the Takbai hospital will visit the blind that got a low score at their home after training in every 1 month, 3 months and 6 months in order to re-evaluate and solve the different problem of each case. The evaluation score will be used in the curriculum improvement for other places.
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| 9. What were the main obstacles encountered and how were they overcome?
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The rehabilitation of the blind on the orientation and mobility in the unsettled situation in Narathiwat province was very difficult to conduct. 5 trainers of the Takbai hospital had to set up the training outside of the hospital according to the plan in all districts in Narathiwat province. There are many obstacles in this project. The main obstacle was the unsettled situation such as the main road was bombed that the trainers could not use that road and had to find a new road which was far than the main road. That situation made the trainers feel unsafe and wasted time. Second, more than 90% of the blind are Muslim that they think that touching between men and women who are not relatives is not allowed. Therefore, the religious leaders of the community were invited to explain to the blind that they are allowed to attend this kind of activities. Third, the villagers in the unsettled situation were quite afraid of attending the activities which were conducted by the government agency for many days since the local terrorists will think that the blind might give their address and other information to the military. That made the blind and their families stay in an unsafe situation, and might be injured by the terrorists. In this case, the community leaders and the religious leaders of the community had to explain the objectives of the training to villagers that this was a medical service for the blind. After the villagers understand the objectives of this training, they all gave good cooperation. The last obstacle was the language barrier because most of the blind speak the Jawi language, the local language, but only 2 of trainers can speak the Jawi language. The ratio of trainers and the blind is 1:5. So, the training time was more than usual. The solution of this case was to find more volunteers and health officers who can communicate in the Jawi language with the blind.
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