S. Suwal1, G. Mareschal1, P. Yadav2, L. Adhikari3, J. Allen4, S. Pokhrel1
1Handicap International, Physical Rehabilitation Activity Program, Kathmandu, Nepal, 2National Trauma Centre, Ministry of Health and Population, Physiotherapy Unit, Kathmandu, Nepal, 3Nepal Physiotherapy Association, Kathmandu, Nepal, 4Canadian Physiotherapy Association, Global Health Division, Ottawa, Canada

Background: In Nepal, importance of Rehabilitation was highlighted, during the health emergency and recovery response to 2015 Nepal Earthquake, especially through the action of Nepal Physiotherapist Association (NEPTA). It enabled environment for integrating rehabilitation in Nepal public health system, although, in 2019, there were still limited numbers (N=40) of physiotherapists employed by Ministry of Health and Population (MOHP) while majority of rehabilitation services were provided by local non-government organizations and private entities.
Nepal is a hot spot for natural disaster because of its susceptibility to seismic and hydro-meteorological hazards, and high socio-economic vulnerability. On the 31st March 2019 two districts (Bara and Parsa) of Nepal experienced unexpected mass causalities caused by a strong windstorm.

Purpose: To demonstrate the role played by rehabilitation stakeholders, particularly NEPTA, in Nepal on integrating rehabilitation service within the health response of 2019 windstorm and the impact of such activity to enable rehabilitation in Nepal health system.

Methods: NEPTA participated to 3 different Health Sector Response Meetings at central and local levels on April 2nd, 3rd and 4th for lobbying the inclusion of rehabilitation in health response to windstorm, while Emergency Medical Team, deployed on April 1st by MOHP, did not include any rehabilitation specialist.    

Results: On April 5th, MOHP decided to deploy Emergency Rehabilitation Services Coalition (ERSC) team, led by NEPTA with the support of Handicap International. ERSC joined the team of the government public health experts in the windstorm affected communities to complete the health needs assessment and provide rehabilitation. Assessment demonstrated that 50% of injured people were discharged from the local hospitals without any rehabilitation, while rehabilitation services were provided to 125 injured people (57% treated in community and 43% in local hospitals) including provision of 90 Assistive Devices.

Conclusion(s): Rehabilitation response delivery for the windstorm injured was the result of a series of coordinated efforts between the government, NEPTA and rehabilitation agencies. This experience shows that national rehabilitation diplomacy and leadership, especially conducted by professional associations, can bring up rehabilitation profile in disaster response.

Implications: Deployment of the ERSC, resulting of NEPTA lobbying, not only enlighten the rehabilitation within health emergency response through provision of rehabilitation service to injured people, but also generated information about rehabilitation towards Nepal health authorities.
Rehabilitation Professional Associations, like NEPTA, have definitively an important role in under-developed rehabilitation systems, for collaborating with health authorities to build up the responsiveness of the rehabilitation system and thereby address the rehabilitation service needs of population in both disaster and non-disaster contexts.

Funding, acknowledgements: NA

Keywords: emergency response, leadership, public health

Topic: Disaster management

Did this work require ethics approval? No
Institution: Handicap International
Committee: Nepal Health Research Council
Reason: The work is addressing developments in Physiotherapy Professional Association to facilitate integration of rehabilitation in health system

All authors, affiliations and abstracts have been published as submitted.

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