Improving access to rehabilitation services during emergency

Interview with Graziella Lippolis, a physiotherapist with Handicap International

Graziella Lippolis, a physiotherapist with Handicap International was in China when the earthquake struck Chengdu, the capital of Sichuan, on 12 May. She took part in the first evaluation mission immediately following the disaster. Below, she talks about the rehabilitation services provided in partner hospitals.

When did you arrive on the scene?

Handicap International arrived in the area on 13 May, twenty-four hours after the earthquake struck. We headed straight to the local hospitals with our doctors and identified the equipment needed to ensure the care-management of hospitalised patients. On 14 May, just two days after the earthquake, we distributed equipment arriving from Beijing by plane, including crutches, wheelchairs, tents and plaster bandages. We then took time to evaluate the hospital's equipment and hardware requirements in more detail, analysed the referral system for the injured, and identified physiotherapy requirements.

What role did you play?

All Chinese staff were assigned to emergency operations. Their main objective during the initial phase was to save lives. Rehabilitation requirements were not taken into account and were not considered to be a priority. If the after-affects of these injuries are not care-managed immediately, however, this can lead to joint contracture, muscular weakness, respiratory problems, and significant loss of functionality. 80% of patients arriving at hospitals suffer from fractures. If they return home with a limb in plaster but without mobilization, this can cause permanent damage, such as a loss of joint mobility.
Patients with amputated limbs who benefit from rehabilitation find it easier to regain their mobility using an artificial limb. Handicap International's physiotherapists demonstrated the basic movements and provided assistance as and when needed. From 26 May, other physiotherapists arrived and were able to start training Chinese physiotherapists.

What are we doing now?

In addition to providing training and direct care, our teams have put in place a number of procedures, including procedures for physiotherapists. The procedure sets out the role of the physiotherapist at various stages of an amputation - post-operative, stabilisation, rehabilitation before the fitting of an artificial limb - with the aim of providing patients with follow-up care for as long as possible.
The initial stage of Handicap International's emergency operation is scheduled to last two months, at which point Handicap International will commence referral/counter-referral operations for earthquake victims suffering from after-affects, thereby ensuring better access to rehabilitation services.

Are services in China adapted to the needs of people with disabilities?

Rehabilitation services do exist, but they are not always in a position to manage after-affects developed as a result of the earthquake. For example, they provide care for patients who are able to move around but do not take into account the extensive needs of people with disabilities who are confined to bed, such as the paralysed and people in comas, etc. The Chinese staff are, therefore, much in demand.

Handicap International has formed partnerships with the West China hospital and Hospital 3 in Chengdu.