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World leaders are finally prioritising rehabilitation in health systems - this will change the lives of millions

Health Rehabilitation Rights
International United Kingdom

George Graham, Chief Executive of Humanity & Inclusion UK The neglect of rehabilitation in health systems around the world is a scandal that harms millions and millions of people. This week's landmark resolution at the World Health Assembly is a gamechanger. Delivered properly, it will transform many, many lives.

By George Graham, Chief Executive of Humanity & Inclusion UK.

Kanha, an 18-year-old girl learning to walk with an above-the-knee prosthesis on her right leg. She is walking across a wobbly bridge with parallel bars, while an HI rehabilitation staff walks alongside her. They are outside in the yard of the Physical Rehabilitation Centre.

Kanha, 18, during a rehabilitation session at Humanity & Inclusion's Physical Rehabilitation Centre in Kampong Cham, Cambodia. | © Lucas Veuve/HI

When I was 18, in the heady summer after my A levels, I was messing around with my brother at home in Somerset when I managed to smash my hand through a window. The glass sliced through the tendons of my left hand, ripping my last two fingers to the bone. It was not a pretty sight.  

With huge thanks to the tremendous work of a South African hand specialist at my local hospital, my fingers were saved. But for five years, I could scarcely bend them, and my grip was terrible. I thought I’d live with an almost-useless left hand forever.

But I was lucky. By and large, the NHS understands the importance of rehabilitation, and I was offered high-quality physiotherapy. Over the years, I kept persevering with the exercises they gave me, until, one day, I finally managed to bend my fingers to my palm and grip properly.  As a result, I was able to get back to the rock climbing and mountaineering that I loved. Now, while I still have a nasty scar, I can clench my fist perfectly.

But for millions of people around the world, access to physiotherapy and other types of rehabilitation after illness or injury is just not available. And when it is, it’s often unaffordable.

This is a global scandal. It means people are living in pain or with permanent impairments every day of their lives. It also prevents millions from earning a decent living, doing huge and avoidable harm to themselves, their families and their communities.

According to figures from the World Health Organisation, there are 2.4 billion people living with a health issue that would benefit from rehabilitation to build up their strength and functioning. Yet in some low- and middle-income countries, more than 50% of people do not have access to these essential services. And in a global context of conflicts, natural disasters, an ageing population and increased use of cars and motorbikes, the problem is only growing.

Turning the tide

This is why it is so exciting that, on 25 May at the World Health Assembly in Geneva, 194 countries have passed a landmark resolution that will commit them for the first time to develop and strengthen rehabilitation in their health systems.

The resolution is the highest level of international commitment. It sets out nine actions for governments, including to increase the physiotherapy, occupational therapy and speech therapy workforce, to develop training and to integrate rehabilitation into their regular healthcare provision.   

After years of being forgotten or ignored – of being the orphan issue in discussions about healthcare – rehabilitation is finally being taken seriously on the world stage.

At Humanity & Inclusion (HI), we know what a transformation this will deliver for so many people.  

In collaboration with other organisations, we have been a leading voice calling for this resolution and persuading governments to take the issue seriously. My colleagues even proposed some of the text.  

HI runs 62 rehabilitation projects in 35 countries around the world. In Jordan, for example, where we are strengthening services in partnership with the Government, we are helping a father of two, Ahmad, who fell from the third storey of a university accommodation block where he was working as a construction worker. He suffered concussion and now has seizures.  

The fall also worsened an existing knee problem that he had never had treatment for. He believes had he received physio for that first injury, he may never have lost his balance on the fateful day that he fell.  

My hand injury was never going to have a major impact on my long-term earning ability, but, for people like Ahmad, having a disability can mean not being able to work and care for their family. Thanks to a grant from HI, Ahmad is now building up a tailoring business, but countless others face a bleak future simply because they did not receive the rehab needed to prevent long-term disability.

Injuries and accidents in poorer countries can have desperate consequences: a broken leg without proper treatment can lead to amputation; rehabilitation is essential to regain muscle strength so that a prosthesis can be fitted and the patient can regain their independence.   

At HI, we are delighted that rehabilitation is finally being treated as the vital, life-changing form of healthcare that we have always known it to be. This resolution is a pivotal moment, which, by encouraging states to develop and fund their rehabilitation services, could truly transform the lives of millions of people like Ahmad. Our experts are ready to support governments as they take up this challenge. 

Date published: 25/05/23

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