International day of persons living with disability: Role of medical rehabilitation in their management

According to the World Health Organisation (WHO), more than a billion people in the world today experience disability. These people generally have poorer health, lower education achievements, fewer economic opportunities and higher rates of poverty. This is largely due to the barriers they face in their everyday lives, rather than their disability. Disability is not only a public health issue, but also a human rights and development issue.

Rehabilitation is instrumental in enabling people with disabilities, whose functions are limited to remain in or return to their home or community, live independently and participate in education, the labour market and civil life. Rehabilitation is a treatment designed to facilitate the process of recovery from injury, illness or disease to as normal a condition as possible. The purpose of rehabilitation is to restore some or all of the patient’s physical, sensory and mental capabilities that were lost due to injury, illness, or disease.

It includes assisting the patient to compensate for deficits that cannot be reversed medically. It is prescribed after many types of injury, illness, or disease, including amputations, arthritis, cancer, cardiac disease, neurological problems, orthopaedic injuries, spinal cord injuries, stroke, cerebral palsy, poliomyelitis, Down syndrome, multiple sclerosis, hydrocephalus, Autism just to mention few.

Rehabilitation is carried out by qualified and certified Medical Rehabilitation professionals which includes Physiotherapists, Occupational Therapists, Speech Therapists and Audiologists, Orthotists and Prosthetists, Chiropractors and Osteopaths. These professionals have been trained in the management of persons living with various forms of disabilities and to help restore them to a near normal condition, while also re-integrating them back into the society.

Disability Day or the International Day of People With Disability is a day that has been promoted by the United Nations since 1992, with the aim of encouraging a better understanding of people affected by a disability, raising awareness about the rights, dignity and welfare of disabled people, and the benefits of integrating disabled persons into every aspect of life, from economic to political, social and cultural.

It is celebrated every year on December 3 with a specific theme, with this year’s theme being “Achieving Seventeen Goals For the Future We Want.’’ These goals were adopted on September 25, 2015, as part of a new sustainable development Goals (SGDs). Each goal has specific targets to be achieved over the next 15 years acting as the post- 2015 Developmental Agenda (Successor to the Millennium Development Goals (MDGs) Sustainable Development Goals (SDGs), officially known as ‘’Transforming our World.’’

The 2030 Agenda for sustainable development are a new, universal set of goals, targets and indicators that United Nations member states will be expected to use to frame their agenda and political policies over the next 15 years. Among the key themes agreed upon were poverty eradication, energy, water and sanitation, good health and human settlement etc. These goals address and incorporate in a balanced way all three dimensions of sustainable development (environment, economics and social) and their inter-linkages and the development of these goals does not divert focus from the achievement of MDGs.

For SDGs to be achieved, everyone needs to play his part; persons living with disabilities (PLWDs) government, private sector, civil society and professionals. Among these professionals are the Medical Rehabilitation experts, whose overall role is to improve the quality of life (QoL) of PLWDs.

In Nigeria, the Federal Government established a Board known as the Medical Rehabilitation Therapists Board of Nigeria under Decree 38 of 1988 /Acts M9 LFN 2004 to regulate and control the training and practice of these rehabilitation professions in the health sector in Nigeria. The roles of medical rehabilitation professionals in health care delivery system in Nigeria cannot be overemphasized especially as it affects management of disabling conditions and persons living with disabilities.

Some of these are to: promote effective means for the prevention of physical disabilities, to manage physical disabilities through a team approach to restore functional independence, to assist for psychological adjustment, to educate the public, to design and develop facilities, to vocationally train persons living with disabilities and to provide educational services to the public and to persons living with disabilities.

Therefore, in order to achieve the sustainable development goals, the procedure of medical rehabilitation has to be comprehensive. A comprehensive medical rehabilitation in this sense can only be achieved through a team approach, which involves contribution of various disciplines mentioned above towards the achievement of a common goal, that is, attainment of functional independence by the PLWDs. This role is not limited to management of disabling diseases or traumatic conditions, rather, it is a form of comprehensive medical and physical management that is directed towards restoring a patient to a normal state of physical, mental and social well-being.

Medical Rehabilitation experts act as health educators and also promote public awareness about the right, dignity, welfare of disabled people and the benefits of integrating disabled person into every aspect of life, from economic to political, social and cultural.
However, some of the challenges facing medical rehabilitation services in Nigeria among others are: inadequate numbers of medical rehabilitation professionals in Nigeria, lack of well equipped medical rehabilitation centres, poor level of awareness on the roles of medical rehabilitations among the patients, public, and the medical practitioners for prompt referrals, inappropriate compensations for individuals that sustained disability as a results of occupational hazards.

In conclusion, Medical Rehabilitation has a central role to play in improving the quality of life of PLWDs. Her role is pertinent to attainment of the highest functional ability. This write up would not be complete without mentioning the effort of the Honourable Minister of Health Prof. Adewole Isaac, towards the approval of National Health Policy 2016, where a section has been dedicated to disabilities and has maintained that people living with disabilities achieve economically productive lives.

The policy orientation is to: integrate disability-related interventions into existing national health programs; institute measures to ensure access to health services by persons living with disability; promote measures to reduce stigma against people living with disability and strengthen the evidence based on disabilities in Nigeria. The main objectives are to reduce the burden of disability in the country.

Olufunke Akanle is the Registrar/CEO of the Medical Rehabilitation Therapists Board of Nigeria