By Dr. Andy Haig
August 27, 2018
In addition to surviving the wild gyrations of a country gone World Cup mad, some 3,000 of the world’s top leaders in physical rehab attended the International Society of Physical and Rehabilitation Medicine (ISPRM) conference in Paris, presenting cutting-edge research and organizing important global programs.
I gave a few talks on how countries can provide rehabilitation response to natural disasters, and along with our Ghanaian fellow Abena Tannor, had a paper on how we’re training Africa’s PM&R specialists in Ghana and Ethiopia. As usual, the real work of the meeting was in committees and hallway conversations. Here’s what’s up:
Disaster Rehabilitation
The science and policy of ensuring that medical rehabilitation is adequate after earthquakes, floods, and other natural disasters is a field we launched in 2009 at the International Rehabilitation Forum in Kayseri, Turkey. It’s exploded into an official committee of the ISPRM and the World Health Organization (WHO).
This year the elephant in the room came out to sit on us all. Unfortunately, ISPRM and WHO have ignored the rehabilitation needs of victims of man-made disasters – partly through ignorance, but also politics. One ISPRM leader declined to help intervene in Syrian refugee camps because we might be “picking sides” in the war. Despite that, this year there was substantial discussion and strategizing on how we can influence policy.
One major strategy I’ve encouraged is directly teaching rehabilitation medicine to military physicians around the world. Even without war, armies are large national organizations that employ many people and are financially responsible not only for their health care, but also for low productivity or absenteeism due to disability. Our protégé, Farooq Rathore, MBBS, and his colleagues in Pakistan provide an excellent model. Pakistan’s only rehabilitation training program is in the Army, but when they had a huge earthquake they had the human capacity to respond to the civilian disaster.
Haig Consulting and our not-for-profit International Rehabilitation Forum (IRF) are now actively seeking contacts in military organizations around the world to see if we can help them build capacity that serves themselves now – and their civilian populations later. Someday these military doctors will retire and go into private practice or academics, thus infiltrating elsewhere!
Low-Resource Rehabilitation
Also in Paris, representatives from emerging economies such as Bangladesh and Malaysia presented highly sophisticated research and demonstrated the viability and – indeed – the crucial place that rehabilitation plays in countries where disability drags down the national economy. Yet many low-income countries have little or no medical rehabilitation.
People are taking notice of our work in Africa, where an online, in-person fellowship is training the very first home-grown PM&R physicians in English-speaking Africa. In several countries or regions with only one or two specialists, there’s an interest in having IRF provide the didactic curriculum while their local doctor can teach the hands-on part. A former Soviet country, a few other African countries and others may jump on board.
I encourage anyone with connections to a country where rehabilitation might flourish to contact me and see if we can pull together a program using this new successful mode.
Hope in Brunei
During the Paris meeting I got a great phone call from a guy who couldn’t make it, Abang Hepnie, MBBS, of Brunei. I’ve worked for years with the current and former Brunei ministers of health and many other national leaders on a vision for rehabilitation in this isolated but highly developed South Asian country. The national leadership gets it – that rehabilitation can optimize the function and quality of life of all society – and has slowly been able to change policy and structure in this direction.
Dr. Abang is a young, super-talented protege. A few years ago they named Abang the chief of the section of “functioning,” including rehabilitation, neurology, and other services, and charged him with improving functioning of society writ large.
They’ve built a beautiful rehabilitation facility on the South China Sea, but political and logistical barriers prevented full rehabilitation services there. Just this week he and Vivian Tie MSPT, MBA, told me that they’ve been given a green light to move rehabilitation services to the facility and fully develop rehabilitation for this wonderful country.
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