The practice of physical medicine and rehabilitation in sub-Saharan Africa and Antarctica: A white paper or a black mark?

Abstract

Antarctica is doing fine. Africa is in a crisis. Local medical schools, hospitals doctors, and persons with disability; along with foreign volunteers, aid groups and policymakers can impact the crisis. However government--specifically national ministries of health--is ultimately responsible for the health and well-being of citizens.

Assessment of Rehabilitation Capacity in Ghana

“…Consistent with previous studies (Tinney et al, 2007;Haig et al, 2009), no physiatrist was identified in the current study. The absence of rehabilitation physicians in Ghana and most of sub-Sahara represents a core barrier to providing the comprehensive rehabilitation care consistent with established international standards.…”

“…The absence of rehabilitation physicians in Ghana and most of sub-Sahara represents a core barrier to providing the comprehensive rehabilitation care consistent with established international standards. In the absence of physiatry, rehabilitation is often provided primarily through PT, occurring primarily in outpatient physiotherapy centres that may or may not be associated with a hospital (Tinney et al, 2007;Haig et al, 2009;Christian et al, 2011). The primary burden of rehabilitation care falls on the PT who is expected to have extensive medical knowledge and appropriate clinical decisionmaking ability, but often in the absence of adequate resources (Dunleavy, 2007).…”

“…However, medical rehabilitation services remain under-developed in low to middleincome countries (LMICs) (Haig et al, 2009;Christian et al, 2011). Limited rehabilitation infrastructure, human resources, and unavailability of evidencebased treatments appear to be barriers to enhancing care in low resource settings that are simultaneously experiencing a rapidly increasing burden of traumarelated disability and disabling chronic diseases (Mock et al, 2003;Lemogoum et al, 2005;Connor and Walker, 2007).…”

“…Sub-Saharan Africa, with its 1.1 billion people, is served by only 6 rehabilitation physicians (physiatrists), all of whom are located in South Africa (Haig et al, 2009). There are an estimated 4,169 occupational therapists (OTs) in Africa, with 75% of them practising in South Africa (World Federation of Occupational Therapists -WFOT, 2011).…”

Provision of prosthetic and orthotic services in low-income countries

“…22 However, there are dissenters to this position. Haig et al 43 in their 2009 article describe CBR as a politically expedient way to allocate the least amount of money possible to the problem. They suggest that CBR is a process of delegating highly skilled rehabilitation treatment to cheap uneducated locals without proper training or sufficient input from medical professionals.…”