Fellow Since 2003
This description of Jeanette Perry's work was prepared when Jeanette Perry was elected to the Ashoka Fellowship in 2003.
For the last 26 years, Jeanette has been promoting the right of people with physical disabilities, particularly those who have had amputations, to have access to quality treatment, including quality prostheses, rehabilitation, and job opportunities. Since 1976, Jeanette has done her pioneer work through her organization CIREC, Pro Cirugía Reconstructiva, which has evolved into one of the leading Latin American organizations focused on the needs of low-income people with disabilities.
The New Idea
Jeanette has succeeded in establishing CIREC as the national reference on disabilities with respect to rehabilitation and social integration. It was one of the first organizations in Colombia to integrate various aspects of work with people with disabilities -- including physical, occupational and psychological therapies, work with families and socialization programs, job training, promotion of employment opportunities, and high quality prostheses -- with the goal of fully reintegrating physically disabled individuals into society. Jeannette’s leadership has led CIREC to become the largest local producer of prosthesis in Latin America, as well as a key advocate for laws that look at the needs of people with disabilities in an integrated way. For Jeanette, it is not enough that the person regain mobility; she is concerned with integrating the individual into the job market and ensuring equality before the law. Over the years, CIREC has directly helped tens of thousands of Colombians from all over the country, as well as many other Latin Americans, to function at high levels in society and in the workplace.
Throughout Latin America, poverty, malnutrition, violence and poor access to healthcare are responsible for high levels of disabilities in the population. In Colombia, theses problems are compounded by the ongoing violence, which has caused physical disabilities in a large percentage of the population. While in 1993 a survey conducted in Colombia calculated that half a million Colombians suffer from physical disabilities, the World Health Organization estimates that the armed conflict has caused that percentage to double in the last ten years. Until approximately a decade ago, disabled people in Colombia had very little access to treatment and rehabilitation programs. They suffered from discrimination not only by society, but also by their families and were often left alone without treatment or hope for education or a normal life. Currently, 84% of the institutions that attend to the disabled are private, and few of those have programs that integrate treatment, occupational therapy, social work, psychological support, and job creation programs. None produce their own low-cost prosthetic devices, key for rehabilitation, especially for low-income families. While Jeanette’s work over the years has contributed to the establishment of a new model of rehabilitation in Colombia that includes reinsertion into the job market as a key component, there is still much work to be done to increase access to such rehabilitation in Colombia and in Latin America. Additionally, while Jeanette’s organization has made great strides in promoting the rights of the disabled to access programs that truly provide rehabilitation, there is still a wide gap between Colombia’s new law which stipulates the right to total coverage, including rehabilitation for the disabled, and the reality. The law does not provide for access to the orthopedic elements necessary for the disabled to achieve autonomy and reenter the workforce. And while there are growing movements that promote tolerance for people with disabilities, there are still many hurdles to overcome. One of the most important challenges is fostering awareness within businesses that could be potential employers about what the disabled are capable of doing, in order to increase their opportunities in the workplace. Moreover, although Jeanette’s center treats patients from outside of Bogotá, the armed conflict, and in many cases the disabilities themselves, make travel difficult. What is needed now is a way to bring services like those of CIREC to Colombia’s various regions.
Throughout the years, Jeanette has brought constant innovation to CIREC and the field of rehabilitation. Now that she has created a methodology that has drastically changed the lives of tens of thousands of disabled people, she is going further by developing new reintegration strategies and decentralizing CIREC’s work in order to treat patients where they live.A key component of CIREC’s methodology has always been producing low-cost prostheses. Since the end of eighties, CIREC has had access to the latest technological system for the design and manufacturing of prostheses. Jeanette was able to establish a long-term relationship with the Swedish Cooperation Program that provided the seed funding used to build CIREC’s facilities. The Swedish group also funded a Computer Assisted Design (CAD/CAM), which is now used to customized prostheses according to the specific needs of each client. CIREC has developed a methodology for creating its own high quality prostheses on its premises, using Colombian materials instead of purchasing expensive materials and prostheses from other countries. Though they are of almost equal quality, CIREC’s prostheses cost one third the price of counterparts from the United States. Not only is CIREC the only rehabilitation center in Colombia to produce its own devices, but also the majority of people who produce them have been through CIREC’s rehabilitation programs. In order to reintegrate disabled people into normal societal roles, CIREC also concentrates on consciousness-raising about disabilities, primarily by working closely with the formal private sector and schools. CIREC has been instrumental in the establishment of “Grupo Formar,” a group of 180 CEOs of the largest companies in Colombia that is concerned with integrating people with disabilities to the job market. CIREC does this consciousness-raising through direct contact with businesspeople, encouraging them to employ people with disabilities as they would any other candidates, based on the abilities they can bring to the job. They also lobby lawmakers and insurance companies to promote laws that stipulate that disabled patients have the right not only to treatment but also to prosthetic devices. Additionally, they have a well-known award program to recognize outstanding achievements by disabled individuals to demonstrate their capabilities to a wide audience. They also work with schools and universities organizing tours of CIREC to raise consciousness amongst these groups and change their generally negative or pitying view of handicapped people. Within this educational component of her idea, Jeanette has also brought in young school children to participate with handicapped children in rehabilitation at CIREC in arts and other handicraft workshops. In the next five years, Jeanette will focus her energies on closing the gap between national laws and the realities of people with disabilities by focusing on those reintegration initiatives and by making CIREC-like services available to people where they live. Jeanette has thought about trying to build more CIREC centers throughout the country; however, she has determined that this is not an efficient way of making sure that her work reaches the majority of people in need. Rather, she is establishing a new program called “Seeds of Hope,” creating nodes that are managed by former patients of CIREC in their own communities. Through these nodes, the Association of Users of CIREC works in conjunction with CIREC to promote social participation and job development mechanisms for people with disabilities in their own communities and to accelerate and sustain their integration into society. The nodes provide training opportunities geared toward personal and occupational growth and the creation of job opportunities. They also work on raising consciousness on a political level about the rights of the disabled. Jeanette is focusing on establishing these nodes in communities that have been particularly affected by the armed conflict in Colombia. Currently, she has nodes operating in Magdalena Medio, Meta and San Vicente de Chucuri. To further bring the work of CIREC to other areas in Colombia, Jeanette plans to introduce a mobile unit that will bring their expensive scanner (CAD/CAM) to people in need of prostheses. That way, her staff can take measurements of disabled people who cannot come to Bogotá and bring them back to CIREC to create the mold for their prostheses. While there are certain activities that they can do with this mobile unit, for severe cases they will still have to send patients to CIREC, where they have an in-patient program. Though this is fairly expensive to do, CIREC has been able to cover its fixed costs (about 30% of the total costs, mainly salaries) through an endowment that was set up at the start of the institution. They are able to pay for 30% of their work through income for services for those who can afford to pay, and the remaining 40% of their funding comes from international donations and general fundraising for specific projects.
Jeanette is a trained physical therapist. When she began to work in poor communities in 1960, there were no occupational therapists, and she was forced to take on their duties herself. While working with a hospital in college, she noted that there was little that the patients could do after they went through their normal rehabilitation programs, so she decided to begin an occupational rehabilitation center in her own garage, where she trained hospital patients in arts, sewing and weaving. Her garage operations later turned into an NGO called IDEAL, the Institute for Labor Adaptation, a pioneer in the field in 1961 and an organization that still operates today. In 1976, Jeanette founded CIREC in order to meet the needs of the physically disabled who did not have access to reconstructive surgery and hip replacements and to “have one less handicapped person on the street and one more worker for Colombia.” While CIREC began as an institute that provided support to heads of low-income families in reconstructive surgery and hip replacements, in 1981 Jeanette felt that it also had to work on rehabilitation for amputees and converted CIREC into a center for integrated rehabilitation and reinsertion into society.