I have been asked to speak to you about international cooperation in physical therapy and would like to tell you a little of what has been achieved so far, what the benefits of being 'international' are, what the benefits of being Regionalised are, what remains to be achieved.

View full abstract

In the United Kingdom, physiotherapy offers a professional career for blind and partially sighted persons in which they can enjoy parity with their sighted colleagues. This position reflects a history dating from the late Nineteenth and early Twentieth Century.

View full abstract

What is health? The Thirties World Health Assembly resolved in1977, that "the main social target of governments and WHO in the coming decades should be the attainment by all citizens of the world by the year2000 of a level of health that will permit them to lead a socially and economically productive life"(resolution WHA 30. 43).

View full abstract

I am very pleased to be with you. I wish to thank Ms Taguchi, President Nara and all the physical therapists we have met who have been such fine hosts and made us feel so welcome. I have been a director of a Physical Therapy education program for over 20 years and before that time I served as a faculty member in the university and a teacher in hospitals and a practitioner. During this period I have been a part of many changes in the education of physical therapists at Northwestern University and have seen the continuing development of our education on a nationaland international bases.

View full abstract

The health care systems of many developed nations are under close scrutiny today because funding bodies, both government and insurance, are concerned about rapidly increasing costs. Some of this cost increase is, of course, due to the growing demand for services, especially accruing from a rapid escalation in the numbers of elderly persons who tend to be heavy users of health care services. A large measure of the cost increase, however, is due to the professionalisation of the health care workers who demand and receive professional salaries or fees for the work they do. For example, a decade ago an Australian physiotherapist commenced work at a salary equivalent to \1,440,000 today, a new graduate begins at \2,400,000 an in-crease of 67% in ten years. Unfortunately, there is very little evidence available at the present time to demonstrate the value, or cost effectiveness, of these health care professionals. We all believe that we are essential but it is difficult to prove it. Health economists in Australia, and in many other countries, are closely examining organisational budgets and many are using very' large shears to prune all unessential costs. Physical therapy is, sadly, one of many disciplines which is likely to have budgets reduced be-cause it has been very slow to develop objective data bases and to institute objective evaluation pro-grams to show precisely what physical therapists have contributed to the care of clients, to show precisely what the effects of that contribution have been, especially in economic terms. As a manager, a major part of my job is ensuring that the services provided by my staff are guided by strategic plans which conform to the objectives of the hospital, have clear goals, targets and performance measures, and are demonstrably effective and efficient. Thus, we work diligently and constantly at evaluation, especially examining processes and procedures to eliminate any activity which does not contribute to a planned outcome. About 70% of the clients in our rehabilitation programs: inpatient, outpatient and domiciliary, are aged 65+. We need to remind ourselves constantly that the life expectancy of an elderly person after a major episode such as a stroke or amputation is not great, 80% living less than 5 years. Thus, old people do not have time to waste in prolonged rehabilitation programs, they want to achieve a particular functional level which will allow them to go home as quickly as possible.

View full abstract

Infant mortality in Chile has experienced a constant decrease which has become quite noticeable in the last thirty years, reaching in 1990 a level of16 per thousand of born alive, one of the lowest in Latin America and which is even lower to what could be expected according to the country's socioeconomic evolution. This reduction has been done overall at the expense of late infant mortality, which constituted in the 1960's decade around 2/3 of the deaths and which now reaches only a 50% of the total. Nevertheless, this national average hide rather important differences among the regions, which range from extremes of a 12.5 per thousand in the First Region to a maximum of 26.6 per thousand in the Ninth Region, La Araucania. If the decrease phenomenon in Total Infant Mortality has been registered, not the same happens with the infant death mortality's proportion produced by Acute Respiratory Infections (ART) which register an even tendency, between a 16 and 17%of deaths in children under 1 year old (16.2% in1990) and continue constituting the first cause of late infant mortality.

View full abstract

[in Japanese]

View full abstract

On the 23 April, 1992, the United Nations organization, the Economic and Social Commission for Asia and the Pacific (ESCAP), proclaimed the Asia and Pacific Decade of Disabled Persons, 1993-2002(resolution 48/3). Between 1-5 December, 1992ESCAP, with the cooperation of the government of China and Disabled People International held a meeting to launch the Asia and Pacific Decade of Disabled Persons". At this meeting the ESCAPAgenda for Action was unanimously approved. The ESCAP Agenda for Action consists of a series of objectives directed towards achieving "the full participation and equality of people with disabilities in Asia and the Pacific". One of the service delivery strategies endorsed in this Agenda is community based rehabilitation (CBR). Endorsement of CBR changes its status from being a theoretical approach to rehabilitation to accepted practice that has now been pilot tested in many places throughout the world.

View full abstract

In a sample of 51 countries scattered in the Western-Pacific Region, South Asia and Africa, 25 countries are reported to have initiated Community-Based Rehabilitation (CBR) projects or programmes. In 13 of these countries CBR is part of the governments plan for rehabilitation. Increasingly, rehabilitation publications include literature and discussion on CBR. Today several newsletters on the subject of CBR are being published in different parts of the world, and have a wide global distribution. Also increasingly, CBR is either the subject of, or a topic on, the agenda of international meetings and symposia. Keeping in mind that it is only just over a decade that the phrase "CBR" came into use to describe a new concept for the development of programs for people who have disability, all these would indicate the degree of it's acceptance globally. Three major factors appear to constrain the generation and extension of CBR, and are relevant to the subject of this paper; 1)The first is the lack of understanding of the CBR concept, and consequent implementation of too many approaches which are CBR only in name; 2)The second relates to this, and is the failure to recognize the role in CBR, of people who have disability; 3)The third is the inadequacy of manpower cadres essential for supporting communities. The term inadequacy refers not so much to numbers, but more importantly, to in-appropriate attitudes and lack of appropriate skills for CBR.

View full abstract

The problems on handicapped people and the elderly people have been becoming complicated in the society, while the mean life expectancy of the population has been extending. Because the ratio of handicapped people and people with senile functional disorder who should receive rehabilitation treatment to the whole population is quite high, the development of rehabilitation medicine and rehabilitation service for those people marks the civilization degree of one country or region. Since 1976, the project of Community-Based Rehabilitation (CBR) driven by WHO (World Health Organization) has been carried out in many countries in the world. CBR plays important and efficient roles in developing the modern rehabilitation medicine and in making the handicapped people re-join the society as well as possible. CBR is a project which would make handicapped people in certain region be recovered in all aspects including the recovery in education, career and social activity. Thus, CBR would provide various regional services for the handicapped people. Therefore, the implement of CBR in different country depends on the manpower, material resources, financial capacity and the need of handicapped people. Since 1986, the CBR has been carried out with certain scopes in many provinces and cities in China. In the aspects of spreading the knowledge of rehabilitation medicine, establishing the organization of modern rehabilitation medicine, and training the professionals, we have got many experiences. A fundamental network of CBR with Chinese characteristics has been built.

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract

[in Japanese]

View full abstract