What Issues Medical Rehabilitation Faces Around The World?
Physical medicine and rehabilitation are an excellent investment because it amplifies human capacity. Yet, a survey of countries, particularly developing nations, shows a massive gap between need and provision of rehabilitation.
- A perfect example is a global survey conducted in 2005. The study aimed to find out how many countries implemented the UN Standard Rules on the Equalization of Opportunities for Persons with Disabilities. Of more than 100 nations, only 38% adopted the rehab policies. Moreover:
- 50% did not pass legislation on rehabilitation.
- 40% did not establish rehabilitation programmes.
- Non-compliance with standards is the smallest challenge rehab faces. A bigger one is the limited access to assistive devices. For example, hearing aid distributors found that the current production level of hearing aids only meets 10% of the worldwide need. In developing countries, that number is reduced to 3%! Of all the people who require hearing aid in countries like India and Africa, only 3% get them.
- Where there are rehab centres, they are limited to urban areas like Chennai. This centralisation and concentration of medical rehabilitation have left tier 2 and 3 cities with inadequate access to services.
- Limited access to assistive devices leads to:
- Deterioration in health
- Restricted activity
- Constraint on participation
- Increased dependency
- Reduced quality of life
- Another issue rehabilitation is tackling, especially in places like India is the insufficient rehabilitation personnel with appropriate training and experience. Lack of proper physiatrists is a significant hurdle physical medicine and rehabilitation has to overcome.
- One more issue that riddles rehabilitation services are legislation. Governments are taking no responsibility for people living with a disability. There is no implementation of policies, and there is a very weak strategic planning. Spending and coverage on rehabilitation and disability are also limited.
To empower people with disabilities, the Government of India has enacted the following legislation over the years:
- Indian Lunacy Act, 1912
- Mental Health Act, 1987
- Rehabilitation Council Of India Act, 1992
- Persons With Disability Act, 1995
- National Trust Act, 1999
- Right To Education Act, 2010
The rights the act provides to those who need medical rehabilitation are:
- Service by a qualified and trained rehab professional who have been registered by the Council.
- Maintenance of a certain standard of professional conduct by the rehabilitation providers. If not met, then the professionals face disciplinary action and even removal from RCI.
- Guarantee that all rehabilitation professionals are under the regulation of a statutory council, which comes under the preview of the central government.
In here, the focus remains on the Rehabilitation Council Of India Act. The legislation was put into practice to:
- Regulate training policies
- Standardise policies
- And regulate programmes in the field of rehabilitation or person with disabilities
The act states that a rehabilitation practitioner should be qualified from an institute recognised by the RCI. Additionally, the practitioner should be registered with RCI. These rules are also applicable to special educators in the field of rehabilitation.
As one of the leading rehab centres in Chennai, we are intimately aware of the shortcomings of rehabilitation. Much needs to be done by the government to overcome the challenges the sector faces.
- More investment and financing are required so that every person of the nation can get easy access to rehab facilities.
- The supply and capacity of personnel need to be amplified. For this, education and training are a must; followed by recruitment and retention.
- The delivery of rehabilitation services must be integrated with the current healthcare system. For example, by coordinating with a hospital in Chennai, we are able to deliver crucial help to dozens of patients each year. It ensures early intervention which leads to more recovered patients.
The last step required to make the lives of those who live with disability better is assistive technology. We have seen first-hand how our patients in Chennai lead happier lives with assistive aids. More local manufacturing, reduction in taxes and good follow-up can make a world of difference.