File
S. Albarawi1, A. Mosa1, M. Idwaima2, C. A. Barth3
1The International Committee of the Red Cross, Physical Rehabilitation Program, Gaza, Palestine, 2The Artificial Limbs and Polio Center, Gaza, Palestine, 3The International Committee of the Red Cross, Physical Rehabilitation Program, Geneva, Switzerland
Background: Palestinian Ministry of Health (MoH) declared a state of emergency in early March 2020 following reporting 5 COVID-19 cases in Gaza. As of July 27, 2020, there have been 76 confirmed imported cases in Gaza. Low initial numbers may be explained by the closure of Gaza and restricted movement, but numbers are expected to increase rapidly within the community due to its high-density population and therefore it was considered important to think ahead of what can be done before losing control.
Purpose: All services and activities have been affected including physiotherapy (PT) which was affected differently depending on the provider, yet with common challenges and experiences. The objective was to understand to which extent physiotherapy services/activities have been affected, how services have been delivered, and to determine challenges and collect recommendations. The idea is to discuss possibilities to adapt/align services for better future planning.
Methods: A questionnaire was developed including both quantitative and qualitative data. It includes the extent to how the pandemic affected physiotherapy services, availability of protective equipment, satisfaction of staff/service users, challenges and recommendations. It was sent via email to 18 key actors/ providers including Palestinian physiotherapy association-Gaza (PPTA), MoH, 9 NGOs, 4 INGO, 1 private and 2 main Universities.
Results: · 9 PT service providers representing 53% were seriously affected; 7 stopped completely, 6 partially, 3 slightly with average 54 days closure. Patient attendance was only 46.9% compared to the same period in previous years
· Services were delivered by a variety of methods, remotely and onsite. Remotely was through phone/video calls, WhatsApp, and video sharing.
· 14/17 providers (82%) received personal protective equipment (PPE), 7 of them with sufficient amount. 23% of PT were satisfied from their work situation while 29.4% patients were satisfied. This is due to many challenges identified: issue of direct contact with patients, reduction of session duration, lack of resources, lack of PPE, adherence problem to home exercise, following patients remotely, constraints in using technology/smart phone, decision makers' lack of interest/awareness of PT role excluding them from trainings on safety and prevention measures.
· INGOs main challenges were related to suspending project activities.
· Academic suffered poor infrastructure of E-Learning, difficulty to explain detailed topics, had to adapt and utilize different software which was frustrating to teachers and students, recommended mix teaching style (face to face & E-Learning), plan practical face to face considering physical distancing, apply infection control strategies.
· Services were delivered by a variety of methods, remotely and onsite. Remotely was through phone/video calls, WhatsApp, and video sharing.
· 14/17 providers (82%) received personal protective equipment (PPE), 7 of them with sufficient amount. 23% of PT were satisfied from their work situation while 29.4% patients were satisfied. This is due to many challenges identified: issue of direct contact with patients, reduction of session duration, lack of resources, lack of PPE, adherence problem to home exercise, following patients remotely, constraints in using technology/smart phone, decision makers' lack of interest/awareness of PT role excluding them from trainings on safety and prevention measures.
· INGOs main challenges were related to suspending project activities.
· Academic suffered poor infrastructure of E-Learning, difficulty to explain detailed topics, had to adapt and utilize different software which was frustrating to teachers and students, recommended mix teaching style (face to face & E-Learning), plan practical face to face considering physical distancing, apply infection control strategies.
Conclusion(s): Efforts should be made to change organizational strategy in provision of services and try to find best solutions to keep services running. In addition to including physiotherapy within response to pandemic. Emergency plan should be adapted accordingly making PPE available, applying protective procedures, establish tele-rehabilitation system, activate outreach program, use home exercise leaflets and consider E-learning programs.
Implications: Discussing possibilities with key stakeholders and decision makers to adapt/align services and education strategy is planned to better align programs for better future planning, ensuring effectiveness of physiotherapy services in Gaza.
Funding, acknowledgements: None
Keywords: COVID-19, Professional issues, Practise
Topic: COVID-19
Did this work require ethics approval? No
Institution: ICRC
Committee: ICRC
Reason: It didn't include patients, it was only targeting institutional openions through mail
All authors, affiliations and abstracts have been published as submitted.
