Rural South Africans' rehabilitation experiences: Case studies from the Northern Cape Province

Background: Rehabilitation is often challenging in South Africa, but South Africans living in remote rural settings might experience unique challenges. Objective: This article interrogates issues of access to rehabilitation in a selected sample from rural South Africa through case studies. Method: This qualitative study utilised a case study design. Eight case studies were done in a purposively sampled rural town in the Northern Cape Province. Data were collected through in-depth interviews. Data were analysed according to the principles of interpretative phenomenological analysis. Results: The case study participants were not integrated into the community. They experienced higher levels of disability than one would expect from their impairments. Their impairments were not modified. No retraining of function was implemented. Early intervention and childhood development activities were not provided. Participants were not linked with selfhelp or peer support groups. Provision of assistive devices was challenged. Environmental barriers aggravated the situation. Conclusion: We theorise that one-on-one therapy is not the solution to the rehabilitation needs of persons with disabilities in remote, rural settings. We recommend a move to community-based rehabilitation and transdisciplinary teamwork supported by family members, community health workers and peer mentors. Therapists are ideally situated to explore the feasibility of such programmes and to pilot them in various communities.