Abstract

BackgroundLong-term disability following natural disasters significantly burdens survivors and the impacted society. Nevertheless, medical rehabilitation programming has been historically neglected in disaster relief planning. ‘NHV’ is a rehabilitation services program comprised of non–governmental organizations (NGOs) (N), local health departments (H), and professional rehabilitation volunteers (V) which aims to improve long-term physical functioning in survivors of the 2008 Sichuan earthquake. We aimed to evaluate the effectiveness of the NHV program.Methods/Findings510 of 591 enrolled earthquake survivors participated in this longitudinal quasi-experimental study (86.3%). The early intervention group (NHV–E) consisted of 298 survivors who received institutional-based rehabilitation (IBR) followed by community-based rehabilitation (CBR); the late intervention group (NHV–L) was comprised of 101 survivors who began rehabilitation one year later. The control group of 111 earthquake survivors did not receive IBR/CBR. Physical functioning was assessed using the Barthel Index (BI). Data were analyzed with a mixed-effects Tobit regression model. Physical functioning was significantly increased in the NHV–E and NHV–L groups at follow-up but not in the control group after adjustment for gender, age, type of injury, and time to measurement. We found significant effects of both NHV (11.14, 95% CI 9.0–13.3) and sponaneaous recovery (5.03; 95% CI 1.73–8.34). The effect of NHV-E (11.3, 95% CI 9.0–13.7) was marginally greater than that of NHV-L (10.7, 95% CI 7.9–13.6). It could, however, not be determined whether specific IBR or CBR program components were effective since individual component exposures were not evaluated.ConclusionOur analysis shows that the NHV improved the long-term physical functioning of Sichuan earthquake survivors with disabling injuries. The comprehensive rehabilitation program benefitted the individual and society, rehabilitation services in China, and international rehabilitation disaster relief planning. Similar IBR/CBR programs should therefore be considered for future large-scale rehabilitation disaster relief efforts.

Highlights

  • Long-term physical disability following natural disasters significantly burdens the impacted society, even more so than immediate medical needs [1,2,3]

  • Our analysis shows that the NHV improved the long-term physical functioning of Sichuan earthquake survivors with disabling injuries

  • Similar institutional-based rehabilitation (IBR)/community-based rehabilitation (CBR) programs should be considered for future large-scale rehabilitation disaster relief efforts

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Summary

Introduction

Long-term physical disability following natural disasters significantly burdens the impacted society, even more so than immediate medical needs [1,2,3]. The Sichuan earthquake of May 12, 2008 affected 46 million people, resulting in 87,476 deaths and over 350,000 persons injured, more than 10,000 of them severely [10,11] Many of these had disabling injuries, including fractures, amputation, spinal cord injury (SCI), and traumatic brain injury (TBI), all of which require physical rehabilitation to optimize long-term physical functioning and prevent medical complications [12,13,14,15,16]. ‘NHV’ is a rehabilitation services program comprised of non–governmental organizations (NGOs) (N), local health departments (H), and professional rehabilitation volunteers (V) which aims to improve long-term physical functioning in survivors of the 2008 Sichuan earthquake.

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