Across the developing world, there are millions of persons with disabilities who need physical rehabilitation services to enable them to go to school, find work and participate in society.
However, in many low income countries there is a severe shortage of local staff with the skills and experience to provide the rehabilitation services needed by persons with disabilities. This can be as a result of poor health care systems which have been destroyed during times of confict; lack of training opportunities; disabled people's issues being low on development agendas.
- When we opened our first rehabilitation centre in Cambodia in 1990, there was not a single qualified Cambodian prosthetist-orthotist – a person qualified to prescribe and fit artificial limbs and braces.
- Sri Lanka needs a minimum of 115 prosthetist-orthotists to meet the needs of the disabled population. There are an estimated 160,000 disabled people who need prostheses and orthoses, including many landmine accident survivors, tsunami survivors and victims of conflict. There are currently only 32 Sri Lankans qualified as prosthetist-orthotists, 28 of whom have been trained by the Cambodia Trust at CSPO and SLSPO.
As a result of this lack of capacity, over 90% of people who require artificial limbs or braces in Sri Lanka have no access to appropriate services. SLSPO is addressing these needs by training local staff. - Timor Leste is another country recovering from conflict and poverty. This young nation also suffers from one of the highest leprosy infection rates in the world: 71 in 10,000 in some communities compared to an international average of 1.5 per 10,000.There are an estimated 6,000 people who need prosthetic and orthotic devices, and currently only one local, trained prosthetist-orthotist, a graduate of CSPO.
- Indonesia has a population of 240 million, with up to 2 million people needing prosthetic and orthotic services. This is an enormous need; the establishment of JSPO is just the first step.
- We particularly encourage women and people with disabilities to train as prosthetist-orthotists: they provide positive role models and female staff reassure women and girls with disabilities who may be afraid to seek support from male rehabilitation specialists.
Results
Building local capacity is an essential step towards building sustainable rehabilitation services for persons with disabilities and reducing reliance on expatriate expertise. As well as training prosthetist-orthotists at our three accredited schools, we also send staff to gain skills as physiotherapists and occupational therapists.
Our focus on this issue is achieving results:
- 132 students have graduted from CSPO since 1994.
- We have now trained enough Cambodian prosthetist-orthotists to staff all the rehabilitation centres across the country. We continue to train Cambodians in this field, in order to ensure a supply of qualified staff as more experienced practitioners move on to teaching and management.
- Our three rehabilitation centres in Cambodia are entirely staffed by Cambodians, with just one expatriate Country Director overseeing the programme.
- We have trained 28 Sri Lankan prosthetist-orthotists.
- One Timorese prosthetist-orthotist has graduated from CSPO and is now working in our partnership project, ASSERT.
- 9 prosthetist-orthotists from Cambodia, Pakistan, Sri Lanka and Lao PDR have graduated from CSPO’s Bachelor Degree programme in collaboration with La Trobe University, Melbourne. They are the future lecturers and leaders of prosthetic and orthotic services in the developing world.
