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Ndayishimiye M.B.1, Rau B.2, Barth C.3
1Saint Kizito Institute, Physiotherapy, Bujumbura, Burundi, 2International Committee of the Red Cross (ICRC), Health (Physical Rehabilitation Programme), Geneva, Switzerland, 3International Committee of the Red Cross (ICRC), Health (Physical Rehabilitation Programme), Bujumbura, Burundi
Background: Political unrest has harmful consequences on human life especially in low income countries such as Burundi, where rehabilitation is still poorly represented. It adds to the burden of diseases as the number of people with disability increases. Interdisciplinary team and humanitarian organisations play an important role in the development of quality of services.
Purpose: The aim of this case study was to demonstrate the importance of interdisciplinarity to ensure optimal functional independence in the management of a person with a spinal cord injury, especially during the political violence that Burundi experienced in 2015.
Methods: Mr EN is a driver aged 33. April 2015 he was shot in the lumbar region which resulted in a L2 incomplete paraplegia ASIA B. He underwent abdominal surgery and was admitted to Saint Kizito rehabilitation institute in June 2015. Three consecutive assessments (June, September and December 2015) describe his rehabilitation. Full rehabilitation (one hour five times a week) following spinal cord management guidelines (www.elearnsci.org) and orthotic devices were provided.
Results: On initial assessment, muscle testing showed level 0 on the left lower limb and 3 on the right lower limb, maximal range of right knee was 95° flexion and no sensation of left lower limb. Locomotion was impossible and he depended on a caretaker for mobility. On subsequent assessment the strength had increased to 4 on the right leg but remained unchanged in the left leg. Flexion range increased to 105°. The 6 minutes walking test was performed with 2 crutches, a left knee foot orthosis and with 3 stops, the walking distance was 50m. Functionally, he was fully independent in a wheelchair. In December 2015, the left leg had not recovered but the right leg reached full strength and 120° knee flexion. The 6 minutes walking test was performed without stop covering a distance of 250m. He reached independence inside the house with crutches and remained dependent on a wheelchair for long distances.
Conclusion(s): The interdisciplinary team and the guidance received from a humanitarian organization played an important role in taking care of victims of political violence. Physiotherapy rehabilitation is shown as the main actor in re-gaining independence for persons with a disability. Hence further studies are recommended to ascertain the importance of rehabilitation in low income countries affected by conflicts.
Implications: Too often people such as M. EN still remain without rehabilitation in Burundi. The findings of this case study will serve as a basis for health agents and the ministries concerned. Indeed, it is essential that rehabilitation is better documented in order to develop and implement adequate policies to answer the needs of the victims of violence and the disabled community in the best possible way.
Funding acknowledgements: n/a
Topic: Disaster management
Ethics approval: descriptive case study with patient approval
All authors, affiliations and abstracts have been published as submitted.
