PHYSIOTHERAPISTS: ENABLING THE DISABLED Written by: Adrian Palmer, SPT UWI MONA, President UWI PTSA The Disability Act was recently passed and a part outlines that disabled citizens should be able to access needed rehabilitation services to receive treatment and prevent any further disability. But how well is our country providing health services needed by our disabled citizens? Physiotherapy is a rehabilitative service that needs to be expanded because it is not easily accessed and is needed by most of our disabled citizens. First, please note Physiotherapists/Physical Therapists are NOT massage therapists, chiropractors, coaches, gym/athletic trainers or the “Come rub dung mi back” person. The WCPT (World Confederation for Physical Therapy) describes a physical therapist as a health care provider who engages in the development, maintenance and restoration of maximum movement and functional ability. They are able to help people from any stage of life, and work when our movement or function are threatened by the ageing process, injuries, environment or diseases (especially those affecting the muscles, bones, heart, lungs, brain and spinal cord). In the Vision 2030 Jamaica National Development Plan for persons with disabilities, a disability is defined as, “any restriction or lack of ability to perform or an activity in the manner or range considered normal for a human being. Such restriction or lack of ability must be as a result of impairment”. By reasoning the two definitions you can conclude that physiotherapists work to correct physical disabilities. The vision statement for persons with disabilities is “a society that is inclusive, accessible, provides opportunities for all and recognizes the rights, freedoms and responsibilities of persons with disabilities in the process of nation building”. However, WCPT indicates if national disability strategies and universal health coverage are to be achieved, access to skilled and well trained physical therapists is essential. This is so because physiotherapists are responsible for the prevention of impairments, activity limitations and disabilities in any persons at risk of altered movement behaviours. Statistics In the 1991 Jamaica census, 4.7% of the population had disabilities and 2001 it was 6.3%. In a July 2014 newspaper article it indicates where Derrick Kellier, Labour and Social Security Minister said some 10% of Jamaicans are disabled. Jamaica’s population is approximately 2.712 million, that means about 271, 200 Jamaicans are disabled. Statin Jamaica (2011), shows that the population 5 years and older that has a difficulty related to walking was 79, 474; population 15 years and older who have a difficulty related to lifting was 94,758 and those that had difficulty related to self care was 43, 345. These thousands of Jamaicans should have access to the necessary medical care, such as physiotherapy that can help them improve their functional abilities. This view is supported by the Disability Act which outlines that “a person with a disability shall be provided with the health services required because of that disability, including screening, early detection, treatment, rehabilitation, identification and interventions as appropriate, and services designed to prevent or minimize any further disability.” Physiotherapy services are available, but are not sufficient and accessible by these citizens. In the MOHE Jamaica Annual report 2007 (published in 2009) showed 36 (Cadre 32) physiotherapists employed in the public sector. That ratio of physiotherapists to Jamaicans is 1:75,333 which is too large. In addition to these shocking statistics, is the fact that physiotherapy services are not available in all our hospitals. Statin Jamaica (2011), showed that the population 5 years and older having difficulty related to walking by parish, St. Mary had 6,660 persons and Portland 4,919 persons. Did you know that there are NO physiotherapists in the public sector in St. Mary or Portland? If anyone of these 11,579 persons should be referred for physiotherapy, they would have to travel all the way to the St. Ann’s Bay Regional Hospital. But this proves to be expensive and not practical. People with disabilities are more than twice as likely to find health providers’ skills and facilities inadequate. This is so in Jamaica because there is little information on rehabilitation professionals and they are rarely considered in health services planning and their skills available are not used as they ought to. The Jamaica Vision 2030 plans include expanding medical rehabilitation facilities by building new centres and upgrading existing facilities; also to expand the number of positions for specialized therapists in government hospitals special schools”. These initiatives were suppose to start under the responsibility of the MOHE in 2012/2013, but now it is 2014 and what is happening? These initiatives are not specific in terms off the rehabilitation services and the type of therapists that will be expanded. Surprisingly, the terms physiotherapy or physical therapy are not mentioned in the document, despite the fact that physiotherapists play two major roles (1) enabling people with long term illnesses and disabilities to become independent and maximize their potential and (2) modification of environments such as home and work place, making them more accessible to people so they can have full participation in their normal roles Other Benefits WCPT states that researches indicate that lack of participation by people with disabilities cost some economies 7% of their gross domestic product (GDP). If you can not appreciate what 7% of GDP is, WHO indicated that Jamaica (2012) expenditure on health was 5.9% of GDP. Jamaica has approximately 10% of the population disabled; our country needs more professionals like physiotherapists who will work to enable the disabled to become productive and participate in nation building. This will reduce economic losses due to disability of our people, and the funds can be channeled into other important areas. The WHO said that rehabilitation services such as physical therapy are good investments because they “build human capacity”. Physiotherapists also treat patients with non-communicable diseases, such as cancers, chronic lung diseases and cardiovascular diseases, which are responsible for more than 65% of deaths in Jamaica. The Jamaica 2008 population estimates show high percentages for: physical inactivity, overweight, obesity and raised blood pressure, blood glucose and cholesterol. Physiotherapists are able to prescribe exercise and help these patients make lifestyle adjustments, so that they can improve their health and daily function. Rehabilitation services such as physiotherapy need to expand, in order to meet national goals and live up to our constitution. The President, WCPT, Marilyn Moffat, said “the message has to go out to Politians and other policy makers that physical therapists are worth the investment”. In our country over 200,000 persons experience difficulty walking, lifting or with self care (I assume, the majority of these persons have a difficulty working or performing other social roles) and over 65% of our deaths are from non-communicable diseases. Physiotherapists play a major role in reducing the prevalence and the severity of disabilities and non-communicable diseases through health promotion and advocacy, disease prevention, treatment and rehabilitation. The approximately 36 physiotherapists can not manage the case load as reflected in the figures above. The promotion and expansion of physiotherapy services in the public sector is of paramount importance to our country. Yes it is on paper, but much work needs to be done on ground. Let us advocate for improvement in our nation’s rehabilitation services so that we can have a health care system that benefits all.
Posted on: Sun, 03 Aug 2014 23:23:08 +0000
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