ZHANG YONGAN, President of Guangdong Disabled Persons’ Federation
I have proudly designed and built the Guangdong Rehabilitation Base for Persons with Disabilities after more than three decades of research in supporting persons with disabilities. The infrastructure meets the criteria set by the International Classification of Functioning, Disability and Health (ICF), a framework approved by WHO states in 2001, with the support of the government.
The Guangdong Rehabilitation Base for Persons with Disabilities
The Guangdong Rehabilitation Base for Persons with Disabilities has a total construction area of 120,000 square meters. It is to be developed in a three-phase process, made available by a total investment of 850 million yuan ($127.45 million). The first phase has been completed and put into use. It has a children’s rehabilitation area and an assistive device area. The children’s rehabilitation area focuses on providing educational rehabilitation services to 600 children having disabilities related to hearing, vision, intelligence, cerebral palsy and autism. The assistive device area has an assistive device museum with engineering rehabilitation, occupational rehabilitation and social rehabilitation facilities. It provides prosthetics, orthotics and other assistive devices as well as occupational ability appraisal services.
The second phase involves the construction of a 300-bed rehabilitation hospital and an institution of rehabilitation sciences (a scientific research institution), a rehabilitation academy focusing on medical rehabilitation, and is expected to be completed in 2023. With the existing 200 beds in the assistive device area, a total of more than 500 beds will be available.
The third phase will be a cultural and sports rehabilitation area focusing on sports and art rehabilitation, providing 300 types of cultural and sports rehabilitation training services. This is now under planning. These facilities will be connected by corridors and the rehabilitation service in each area will be integrated. Various rehabilitation therapies such as PT, OT, ST, AT and RT as well as educational, social, occupational and other measures will be applied in a comprehensive and coordinated manner in order to enable optimal rehabilitation.
The Rehabilitation Base features a terraced, green design. Every plant, every brick and every tile is designed to be part of the rehabilitation processes. The Rehabilitation Base is jointly operated and managed by the Guangdong Educational Rehabilitation Center for Children with Disabilities (Category I institution of public welfare) and the Guangdong Rehabilitation Hospital (Category II institution of public welfare).
The core of ICF is a modern comprehensive model combining psychological, social and environmental factors based on biomedical model (see the relationship diagram of ICF, ICD, and ICIDH). ICD attempts to address health problems by eliminating symptoms, curing diseases, achieving recovery, and restoring health, while ICF is designed to tackle health problems caused by factors other than diseases, aiming to remove barriers, slowing down functional decline, regaining and maintaining optimal functional status. In health services, ICF and ICD are inseparable and complimentary.
The Relationship Diagram of ICF, ICD and ICIDH
There are two concepts: disability and rehabilitation. Disability is a dynamic and evolving process, assessed by the impairment of the interaction between biological individuals and the environment. Rehabilitation refers to the acquisition and maintenance of an optimal state of functions in a person who is or may be suffering disabilities, through assistance including the comprehensive and coordinated use of a range of medical, educational, social and occupational measures.
University of Health and Rehabilitation Sciences
China has made two major innovations based on WHO’s ICF framework, namely setting up the University of Health and Rehabilitation Sciences and the Rehabilitation Base. The University, established at the initiative of Zhang Haidi, president of China Disabled Persons’ Federation and located in Qingdao, Shandong province, will apply ICF to education. The Rehabilitation Base established by Guangdong province in Guangzhou as a base for clinical teaching and internship involves the practice of the framework in the clinical field. China will also continue to explore the development of disciplines in education based on the ICF framework, and advance the building of a new discipline system for rehabilitation sciences.
Guangdong province has stepped up efforts to develop an international model for ICF application in China, and contribute to China’s endeavors to create a new discipline system of rehabilitation sciences and take the lead in international rehabilitation services.
ICF系统理论的中国实践：广东省残疾人康复基地
广东省残疾人联合会理事长 张永安
在政府重视支持下，康复基地是按照2001年WHO公布的ICF系统理论所倡导的国际先进理念而设计建造的，也是我从事残疾人工作30年实践思考并潜心打造的得意之作。
康复基地总建筑面积12万平方米，投资8.5亿元，分为三期建设，首期工程以教育康复为主的儿童康复区，为听力、视力、智力、脑瘫、孤独症五类600个残疾儿童提供康复服务，以及以融合工程康复、职业康复和社会康复为一体的辅具资源区，提供假肢矫形器等辅具适配服务、职业能力鉴定和辅具科普馆服务，已建成投入使用。二期工程以医疗康复为主的康复医院（300张床位）和康复科学院（科研机构），整合辅具资源区（200张床位）和文体康复区，总床位达500张以上，2023年竣工。三期工程以体育康复和艺术康复为主的文体康复区，提供300人文体康复训练服务，筹建之中。三期工程全部建成后将以连廊的形式连成一体，各个区域的康复学科有机整合，综合协调运用PT、OT、ST、AT、RT等多种医疗康复治疗手段，以及教育的、社会的、职业的等一系列措施，以求最佳康复效果。
建筑风格为梯田式绿色主题，蓬勃向上，一草一木，一砖一瓦都具有园艺治疗康复功效。康复基地将由广东省残疾儿童教育康复中心（公益一类）和广东省康复医院（公益二类）两个公益机构负责运营管理。
ICF系统理论的核心内容就是在生物医学模式的基础上，整合心理、社会和环境等因素形成现代综合模式。ICD研究解决疾病引起的健康问题，ICF研究解决非疾病引起的健康问题。在健康服务领域，离开ICD讲ICF靠不住，只讲ICD不讲ICF远远不够。两个基本概念，即残疾概念与康复概念。残疾概念：残疾是个动态演变过程，用生物个体与环境相互作用的障碍结果来评判。康复概念：康复的本义是指恢复到健康状态，其最新定义是指综合地和协调地运用医学的、教育的、社会的和职业的等一系列措施，帮助经历残疾或可能经历残疾的个体，在与环境相互作用的过程中获得并维持最佳功能状态。
2001年WHO年发布的ICF系统理论在中国实践和具体应用产生两大创新成果：康复大学和康复基地。在中国残联主席张海迪倡导下，国家在山东青岛建立的康复大学是ICF系统理论在教育领域的实践应用成果，广东省在广州建立的康复基地作为康复大学临床教学实习基地是ICF系统理论在临床领域的实践应用成果。在两大创新成果的基础上，我们将依据ICF系统理论在教育领域的学科体系建设上继续探索，推动创建康复科学新学科体系。广东省正在潜心打造ICF系统理论中国实践的国际样板，为国家创建康复科学新学科体系、示范引领国际康复服务作出贡献。
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