Stretching Through Life

The Rising Popularity of Physiotherapy and Chiropractic Clinics

As people in urban areas such as Addis Ababa find themselves grappling with changing lifestyles and income levels, they are also becoming aware of the benefits of physiotherapy clinics. Once the domain of clinics and hospitals providing limited services to people with disabilities or those involved in accidents, physiotherapy education and services are spreading throughout the country. As the demand increases, the number of clinics is also steadily increasing, although insiders say there is a long way to go. EBR’s Menna Asrat reports.

Changing lifestyles and perusing more sedentary careers are changing the way many people in Addis Ababa deal with and relate to their health. On top of getting medical treatment people are realizing the benefits of physiotherapy and flocking towards physiotherapy clinics in droves for issues ranging from nerve pain to mobility issues. In order to satisfy this demand, an increasing number of physiotherapy clinics are opening their doors to provide services to people from all walks of life, and from all income levels.

Ermias Belay, 60, is one of them. A few years ago, after a fall when he was walking too work, he started experiencing mobility issues in his neck, shoulder and arm. His doctor was able to deal with the physical injuries and pain that came with his accident, but getting his full range of motion back was a challenge. “A friend of mine told me about a physiotherapist he had visited,” Ermias tells EBR. “He told me that he and his family members had visited the clinic for various issues, including long lasting headaches and back pain. He recommended that I visit them as well.”

Ermias made an appointment with the clinic and went in for his first session. He was a little confused to find that the staff put him through a range of exercises. It was challenging and even painful at first, but slowly, he found his range of motion in his neck and shoulder was improving. “I almost wasn’t able to turn my head but I’m getting a lot better,” he says. “I’m glad I went.”

Ermias is not alone. Gelila Dawit is a 16 year old student. An avid reader, she developed problems in her neck from improper posture at her desk on in her room when she studied, which caused chronic headaches. After going from doctor to doctor, her mother found out that a friend had gone to a physiotherapy clinic and was recovering from the same issue. “If I hadn’t heard about it from my mother’s friend, I would still be having problems,” says Gelila. “As it is, I’m getting a lot better and I’m able to go about my day to day life almost totally pain free.”
Physiotherapy is the medical field that deals with the treatment of injuries, disabilities and illness through manual therapy, movement, exercise, and temperature, and it has a science-based, whole body concentration. The focus of the field is on rehabilitation, allowing people to deal with their injuries and return to their everyday lives, as Ermias was able to.

While physiotherapy in Ethiopia only has a history that is a few decades long, the profession itself began in hospital-based settings to address the rehabilitation needs resulting from World War I casualties and for individuals impacted by disease epidemics, like polio. The role of physiotherapists in cardiac rehabilitation started expanding in the 1950s. In 1952, physiotherapists openly questioned the need for enforced bed rest and prolonged inactivity after a myocardial infarction, which was put forward in 1930s by two physicians. Based on the work performed in a Boston hospital during the 1940s, they concluded that the long, continued bed rest “decreases functional capacity,
saps morale and provokes complications.” This foreshadowed the focus on rehabilitation that the profession would bring forward into the 21st century, with the profession now consider movement as an essential element of health and well-being, which is dependent upon the integrated, coordinated function of the human body at a number of levels.

Ermias is just one of the new crop of patients who are visiting physiotherapy clinics for rehabilitation treatment after injuries or surgery. Even though some, like Ermias, go in for injuries, the rise of non-communicable diseases has also made an impact on the profession.

Nebiyou Tesfaye, senior physiotherapist and medical director of Droga Physiotherapy Clinic, says that, although there is a lack of concreate studies on the subject, in his experience, the rate of patients come in with issues like back pain has increased. “I would say that, at a very rough guess, about 70Pct of people come in with back pain. Of course, a comprehensive study would have to be done on the subject, but as a professional, I would say that many of these issues are caused by improper posture when people sit at their desks, and the lack of exercise that people get on a daily basis.”

But historically, at least in Ethiopia, physiotherapy was not as popular or widespread as it is now. Nebiyou explains that the profession of physiotherapy had to pass through many obstacles before reaching this point. “The lack of education and awareness about what exactly physiotherapy is presented the biggest challenge,” he says. “People weren’t aware of the benefits of rehabilitation, or thought it was just for people with disabilities. The profession is in its infancy in Ethiopia.”

Industry insiders say that this ties in with the neglect of the medical community and the government towards rehabilitative and palliative medicine in Ethiopia as a whole. “I really don’t think the government understand the benefits of any types of medicine that aren’t treatment-based,” says another physiotherapist. “Physiotherapy is designed not to address any specific illness but to help people get back the full use of their bodies.”

At the same time, there weren’t enough professional physiotherapists to address the existing demand for treatment. “A big problem that we faced was that even those who had the training were leaving the profession to go to other countries for better opportunities, or better pay. But now that there are more rigorous training programs and the profession is becoming well-understood, the situation is getting better.”

A 2017 study titled “Empowering the Physiotherapy Profession in Ethiopia through Leadership Development within the Doctoring Process” by Cheryl Burditt Footer and Hailu Seifu, which looked into the provision of education to aspiring physiotherapists found that, “At the beginning of the twenty-first century, Ethiopia had only 13 physiotherapists registered to serve an estimated 15 million Ethiopians living with disabilities. In response to the critical shortage of a workforce capacity, volunteers from the Netherlands and a team of Ethiopian physicians pioneered the Department of Physiotherapy at University of Gondar. The first cohort of physiotherapists graduated in 2006, with a total estimated graduation of 223 therapists as of 2016.”

However, there is still a long way to go, according to those who work in the field. “I would hope that in the future, more people would know about what we do,” says Nebiyou. “I would also hope that the government would start giving more attention to rehabilitation. We’ve come a long way, but we still have a long way to go.”

As awareness of the benefits of physical and rehabilitative treatments grows in Ethiopia, and more people start to become aware of the available services, word of mouth is becoming one of the most important ways of letting the public know of their options.

8th Year • May.16 – Jun.15 2019 • No. 74

Menna Asrat

Deputy Editor-inChief

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