Rehabilitation for Survivors of Torture: Observations from Humanity and Inclusion
Original Editor - User Name
Top Contributors - Naomi O'Reilly, Wanda van Niekerk, Kim Jackson and Kirenga Bamurange Liliane
Value Added Practice and Considerations for Enhancement in Migrant Care[edit | edit source]
Physiotherapy services are being used to support the recovery of survivors of torture within an interdisciplinary setting. As the contexts of the victims are changing and new ways are needed to increase access to physiotherapy for the users, it is important to back up these needs with more evidence based practice allowing smooth integration of physiotherapy practice in the mental health driven care models currently. This situation presents a significant challenge to the activity set up and needs attention and consideration from the field actors and stakeholders making the care possible and involved in it. Evidence based practices available so far suggest that they need to be scaled up and proposed as complete activities, either as standalone or in a care chain as difficulties in context allow, for patients and the care team monitored by clinical practice scaling, with use of common outcome measures, operational research and capacity building of the workforce involved. Techniques applied and their modalities should pay attention to the specific background and particular ‘ history of the patients' traumatic experiences to withhold trust and therapeutic connexion with the patient. As there is a need to continue developing research and translate this research into practice for the field, it should also be backed up by adapting the methods of delivery of the services to constant changing environments. The ultimate goal for the physiotherapy is to ensure that the patient can integrate the acquired skills from the treatment into their recovery and reconstruction process. This should not be limited to the therapeutic compliance only face to face, but should be put in perspective with minimum conditions of safety, protection and benefit of basic needs. The shift of care as recovery advances and its follow-up and ultimately discharge from treatment should also be taken into account in the care model of physiotherapy, be it to equip the patient with skills that can use to increase their resilience as well as promote elements of an inclusive immediate living environment the recovered person can return too at community level.
Rational for Enhancing the Role of Physiotherapy[edit | edit source]
Physiotherapy services are considered as a significant care component for enhancing parts and phases of the recovery of survivors of torture, especially when the first intake of these patients shows lesions and injuries requiring physical rehabilitation in order to recover from injury and regain normal function again. It is known that the effects of Violence and Torture, having a devastating impact on the individual and their environment, are not only physical but of a psychological nature as well. It is crucial therefore to have all necessary services (medical, psychological, legal, social) aligned in the most appropriate and relevant way for the benefit to the patient in order to maximise a recovery that should make sense to them and their surroundings .
More recent development in the humanitarian space relating to increased migration of populations that are exposed to a higher risk of contact with violence / injury events and effects, service provision for this population got more attention from a small number of experienced health providers in physical and psychological rehabilitation attempting to raise more attention to the needs for these victims beyond the classical medical and psychological approach and its available evidence base .
Alongside the pool of health professionals working with this population, physiotherapist staff working in these conditions/environments face important challenges on how to combine functional recovery with the special and unique needs these patients have when it comes to managing the symptoms and complaints the patients present with once the first wave of physical impairments (muscular skeletal, neurological,…) have been addressed and should answer to the widely accepted holistic recovery path when possible.
At this point, physiotherapist and/or rehabilitation workers are confronted with an additional therapeutic questioning that, at times, is addressed by a range of approaches such as specialised and dedicated treatment techniques combining other care elements beyond the classical body systems and structures ’ observation that physiotherapy uses. They include managing the clinical signs of persistent pain, for example altered body perception by the patient, reactions towards flashbacks relating to traumatic events leading to a continuing search for solutions and self-care options to help the patient manage the signs, live with them, insert them in the patient's own resilience pattern and daily life struggles that they are trying to overcome .
Taking this into consideration, it is inconceivable that physiotherapy is being able to address these issues alone, and there is a need to integrate these issues through the wider circle of health care workers that need to offer and share their specialties (mental health professionals, medical specialties, social workers, legal experts ,… ) in the holistic care program of the patient that was formulated during of the initial intake into the care program .
Resources[edit | edit source]
- bulleted list
- x
or
- numbered list
- x
