Shortage of physiotherapists hits government hospitals

FOR nearly three months, Parirenyatwa Hospital became Joshua’s home after he was admitted there following a serious car accident which left him nursing a dislocated hip and several shattered ribs.

His condition meant that he needed the services of a physiotherapist to help him recover from the injuries.
But a critical shortage of physiotherapists in government hospitals, including one of the country’s largest referral hospitals (Parirenyatwa), meant that Joshua (not his real name) had to skip many physiotherapy sessions, hence his prolonged stay in hospital.

For critically injured patients, physiotherapy sessions should be done at least four times a day to help prevent and minimise disabilities that might occur as a result of the injuries.

When attending to a patient with a traumatic brain injury, a physiotherapist might be required at least three times a day to suction the patient.

With bills accumulating and him, an unemployed father of two, not getting enough specialist attention, Joshua had to negotiate his discharge from the public health facility before fully recovering.

Joshua is one of hundreds, if not thousands, of other road traffic accident victims languishing in the country’s public hospitals and not getting adequate physiotherapy treatment due to a severe shortage of manpower.

Zimbabwe Physiotherapy Association president, Peter Mhariwa, said for accident victims, physiotherapists were required right from the scene of the accident until they get back to work or their life stations.

Because of the shortage of physiotherapists one finds that where patients could have strengthened their remaining musculature (the system or arrangement in a body part of the body, or any organ) and achieved their highest level of independence, which in some cases is returning to pre-road traffic accident condition, their woes from the accident injury may persist, leaving them with a permanent disability, which limits their activities of daily living, restricts their participation in life and generally their independence is hampered.

There is also need to strengthen existing community-based rehabilitation programmes so that patients can continue with their rehabilitation at or near their homes once discharged instead of returning to the hospital every time they need to go through a physiotherapy session.

Given the rising number of accidents in Zimbabwe due to the poor state of the country’s roads, it can only point to disaster in the making in view of the critical shortage of physiotherapists in government hospitals.

According to the Zimbabwe Republic Police, 700 people were injured in 99 traffic accidents that killed 100 others in November 2016 alone.

Because of the heavy costs involved in accessing treatment in private hospitals, many people end up seeking help in government hospitals.

All in all, the country has 377 practising physiotherapists against the ideal number of 470.

Most of the physiotherapists work for private hospitals where salaries and working conditions are much better.
In public institutions, the staff numbers are dire.

For example, Harare Central Hospital has 18 physiotherapists while Parirenyatwa, which has a patient capacity of 18 000, has 12 physiotherapists.

The University of Zimbabwe is the only institution that trains physiotherapists in the country, taking an average of 25 students per intake.

This is because the country’s oldest university has limited equipment that cannot cater for a larger intake.
Compounding the shortage is the fact that there is currently a recruitment freeze in government hospitals, which came into effect in 2011.

Some of the physiotherapists who graduated in 2015 are still unemployed because of the recruitment freeze.
Those who are fortunate to find employment in the public sector are de-motivated by poor remuneration of US$525 per month while working under difficult conditions.

Recently, their on-call allowances were scrapped.

Their counterparts in private practice get an average monthly salary of about US$1 500.

Those in South African earn around R19 892, which is an equivalence of about US$2 840.

Countries such as Namibia are attracting physiotherapy interns from Zimbabwe who then register in that country after a year under supervision.

And once registered with that country’s Namibian Health Board, they are eligible to earn an average salary of US$2 150 per month.

In Australia, physiotherapists earn between US$4 500 and US$7 500 per month and some as high as US$10 000.
In Namibia, the government has taken measures to ensure that public hospitals have adequate physiotherapists. (Visit www.fingaz. co.zw for full story)

For example, Namibian Motor Vehicle Accident (MVA) fund, created by government, subcontracts private physiotherapists from all over the country to assist all accident victims with free physiotherapy treatment at the expense of the national fund.

The fund was created after realising that there was a huge shortage of government therapists against an increase in the death toll from road accidents.

As such, the Namibian government introduced a five percent fuel levy directed towards the road traffic accident national fund to take care of all accident survivors’ medical costs and income losses incurred during their time in hospital.

Botswana has also followed in Namibia’s footsteps with a similar fund covering visitors to that country.
“If you’re injured in a road accident during your visit to Botswana, the MVA fund may be able to help with the cost of treatment and the support you need while you’re here, but once you return to your country the benefits cease,” reads part of Botswana’s MVA Fund Act no 15 of 2007.

A physiotherapist based in Windhoek, Namibia, Munashe Chinyama, said the shortage of professionals in the field needs to be urgently addressed.

“If injured patients are left unattended for long, the recovery time and the period of hospital stay will be longer, which raises government’s cost of healthcare provision,” said Chinyama. – Fingaz

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