Mapinduzi J.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 insecurity is common in the world, especially in developing countries such as Burundi. This situation has negative effects on the population's life. Many people are seriously injured and most of them become physically disabled. Their rehabilitation represents a big challenge comparable to climbing mount Kilimanjaro. Indeed, rehabilitation services are often poorly developed and recognized and there are only a few trained professionals (around 25 graduated physiotherapists in Burundi for a population of 11 millions). Ascertaining the role of the rehabilitation team will help to show the Burundi population the value of physiotherapy to regain independence and quality of life.
Purpose: The aim of this Burundi case study is to present the role of the multidisciplinary team and the place of physiotherapy during the political insecurity in 2015.
Methods: Mr IB is a house builder aged 24. Suffering from a brain injury due to a gut shot he was picked up and brought to Kamenge military hospital intensive care unit by Médecins sans Frontières and later transferred to their rehabilitation unit. He then disappeared and was found again and admitted to Saint Kizito rehabilitation Institute supported by the International Committee of the Red Cross (ICRC). Assessments using an ICRC tool (based on the ICF classification) were made at admission (June 2016), after 2 months and at discharge (October 2016). Basic neurological rehabilitation following ICRC protocol and expatriates guidance was performed.
Results: At the end of this study we found that pain passed from high (VAS >7) to 0, joint mobility was partial and increased to normal in all joints, muscle strength was around 3 at the first assessment for the main muscles and increased to 5. Daily life activities based on a score of 50, moved from 15 to 22.5 and 27.5. Function such as sitting was impossible at admission and became performed under assistance at discharge. Walking endurance improved from initially less than 2 minutes without a break to then 10 and finally 30 minutes (with a crutch).
Mr IB became partially independent in his daily life activities and his family was trained in giving appropriate support. In addition, an ankle foot orthosis was fabricated by the orthotist and the interdisciplinary team revised his progress weekly.
Conclusion(s): The support of the ICRC and the benefit of a multidisciplinary team approach proved to be essential in these challenging times. Our study showed that a well conducted rehabilitation programme leads to a positive and sufficient function which provided best quality of life for Mr IB.
Implications: The findings of this study may serve as a basis for the health ministry of Burundi to highlight the role of a multidisciplinary team and the support of humanitarian organizations in taking care of victims of political violence. Too few studies emphasize the importance of trained rehabilitation professionals and implementation of effective guidelines to ensure quality of services in times of conflict and peace.
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.
