The history of disability and rehabilitation in rural South Africa: hidden rural disability and the power of collaboration

Introduction Rehabilitation and disability services in South Africa have been profoundly shaped by apartheid policies, post-apartheid reforms, and global disability rights movements. Rural and remote areas continue to experience inequitable access to rehabilitation services. This article explores the historical evolution of disability and rehabilitation in rural South Africa from the 1960s to the present, with particular attention to community-based rehabilitation (CBR), end-user participation, and collaborative approaches that have emerged in response to rural inequities.Methods A qualitative document review was conducted using multiple archival documents housed by the Disability Action Research Team. The review included unpublished reports, policy documents, program records, training materials, evaluations, and organisational archives spanning more than five decades. Data were analysed thematically to identify key historical phases, actors, and conceptual shifts in rural rehabilitation practice.Results Archival evidence reveals how faith-based initiatives, rural therapists, and organisations of persons with disabilities exposed previously 'hidden' rural disability, catalysed the development of CBR, and influenced national rehabilitation and disability policy. Despite significant progress, persistent challenges related to funding, workforce shortages, and policy implementation remain.Conclusion Collaboration with end users has been central to advancing disability rights and rehabilitation in rural South Africa. Sustained investment, recognition of community-based rehabilitation workers, and community-driven solutions are essential to achieving equitable and accessible rehabilitation services in rural and remote contexts.Key words accessibility, community-based rehabilitation, disability history, equity, qualitative document review, rural South Africa.