Most of the medical institutions and hospitals in the country either have scanty or no physical medicine and rehabilitation (PMR) department to provide rehabilitation services to patients suffering from spinal cord injury, brain injury, stroke, amputations, cerebral palsy bleeding problems such as hemophilia and other disabilities.
Physical Medicine and Rehabilitation (PMR) is a branch of modern (allopathic) system of medicine that improves functional ability and quality of life to those with disabilities.
However, despite the Medical Council of India (MCI) directives, issued nearly 20 years ago, to the medical institutions to set up PMR departments, majority of States have failed to comply with it. Taking cognisance in the matter, the Court of Chief Commissioner for Persons with Disabilities (CCPD) has recently issued a notice to the MCI for failing to ensure setting up the same.
Dr Satendra Singh, an associate professor of physiology at the University College of Medical Sciences and GTB. Hospital in Delhi rued that this neglect perhaps also explains why there is an acute shortage of trained medical professionals for the rehabilitation of patients.
He noted that despite several guidelines to the effect, “PMR departments are non-existent or scanty in medical colleges of many States”. For instance, while Madhya Pradesh, Chhattisgarh, Andhra Pradesh, Telangana, Maharashtra, Gujarat, Odisha, Assam, Tripura, Nagaland, Mizoram, Sikkim, Jharkhand, Haryana, Punjab and Delhi - under State Government - did not possess any PMR departments, some other States only had a few, a grossly insufficient number considering the population size.
Karnataka has a couple departments, Bihar, Uttar Pradesh, Uttarakhand and Himachal Pradesh have one each while some places like Chandigarh, Meghalaya and even one in Uttar Pradesh (Meerut) had departments which were non-functional, said Dr Singh who is suffering with 70 per cent locomotor disability.
In fact, even the national institute to deal with physical disablement, the Pandit Deendayal Upadhyaya Institute of Physically Handicapped, under the Union Social Empowerment Ministry does not have a PMR department, the activist noted.
In early 1995, MCI had directed every medical colleges to start a department of PMR and had also written to all the State health secretaries, registrars of the universities having medical faculty and deemed universities as well as the deans and principals of medical colleges in this regard.
“In case of paucity of PMR specialists, efforts should be made to encourage specialists from preclinical departments like anatomy and physiology to undergo a six-month supervisory training under mentor PMR department to equate them at par with PMR specialists,” Dr Singh said.
Setting up such PMR departments can no longer be ignored given that populations are ageing, and the number of people living with NCDs and the consequences of injuries is increasing. The WHO too says that rehabilitation is part of universal health coverage and should be incorporated into the package of essential services, along with prevention, promotion, treatment and palliation.
The Rehabilitation 2030: a call for action, issued early this year by the global health agency has called upon the member nations to take actions to strengthen rehabilitation services to help people not only to live longer, but to also live well.