Global Rehabilitation – Addressing the Need for Early, Safe, Continuous and Widespread Rehabilitation in Low- and Middle-Income Countries

Abstract

<i>Background:</i> Scaling-up surgical care is one of the most important goals in improving global health and long-term development, where specific attention is directed towards diagnosis and treatment of traumatic injuries, as well as to certain conditions, with varying frequencies between continents and countries. Successful outcome after surgery depends also on safe, efficient and widespread rehabilitation, including both short- and long-term engagement of physiotherapists and occupational therapists. However, relatively little attention has been paid to rehabilitation after trauma and surgery for injuries and various conditions in a global perspective. In fact, the access to rehabilitation in low- and middle-income countries (LMIC) is believed to be enormous. <i>Objective:</i> Through a shared project between two University Hospitals in Zimbabwe and Sweden, our objective was to create an academic partnership with the goal of improving rehabilitation after hand injuries in Zimbabwe. <i>Results:</i> Except geographical, political and patient-related factors, we found that prolonged or inadequate immobilisation after hand injuries and poor teamwork between surgeons and therapists were important factors that complicated the patient care. We give examples on how educational programs in rehabilitation could be organized with focus on creating a close alliance between surgeons and therapists. <i>Conclusion:</i> Creating academic partnerships between universities and hospitals can be of mutual benefit and may be a model for spreading knowledge and strengthen health care systems. Collaboration between therapists and surgeons can be strengthened through integrated courses adapted to existing local circumstances, exchange programs and on-line education, which can be organized between specific departments in different countries. We launch the concept of Global Rehabilitation and give examples of how teaching posttraumatic and postoperative management of hand surgical injuries and common conditions could be structured.