Nigeria has only 1,000 physiotherapists, say experts
THE level of wastages and inadequacies in the field of rehabilitation medicine has been brought to the fore, as physiotherapists under the aegis of the Nigeria Society of Physiotherapists (NSP) revealed that the nation’s healthcare system is surviving with just 1,000 physiotherapists.
Speaking exclusively to The Guardian in Lagos on the issue, NSP President, Taiwo Oyewumi, also revealed that the nation could only boast of 4,000 registered physiotherapists, even as he explained that 50 percent of the nation’s registered physiotherapists have migrated to seek greener pasture.
Oyewumi said: “The unfortunate thing is that less than 1,000 physiotherapists are gainful employed. There is job for the other 3,000 physiotherapists, but it is not being created. In a 750-bed hospital, for instance, where we are supposed to have 70 physiotherapists, we are having only six.
Eventually, it is Nigerians who are suffering these deficits, because they are not having the best. Out of these 4,000 registered practitioners, more than 50 percent of them have migrated outside the country.”
Physiotherapy is the therapeutic use of physical agents or means, such as massage, exercises, water among others, rather than drugs, in the field of medicine, to treat diseases, bodily defects, or weaknesses, such as heart attack, diabetes, stroke among others. Although the global ratio of physiotherapists stands at 1 to 4,000 people, Nigeria has one of the worst ratios in the world: 1 to 170,000 persons, after recording a shortfall of more than 40,000.
Nigeria needs about 42,500 physiotherapists to be able to meet the growing demands of Nigerians. Provost and Senior Vice President of San Diego State University, U.S, Prof. Chukwuka S. Enwemeka, a physiotherapist, who explained the implications of the shortfall to The Guardian in Lagos, stated that patients in need of post-operative care would not be able to get it.
Enwemeka, who holds Bachelor of Physiotherapy degree from the University of Ibadan (UI), Nigeria, is one of the leading authorities in the field of laser therapy in the world, after leading series of researches that led to the discovery on how to use light to heal wounds, kill drug-resistant bacteria among others.
Enwemeka told The Guardian that lack of enabling environment for the practice of physiotherapy in Nigeria has been one of the reasons why Nigerians seek medical care abroad. Aside engaging qualified physiotherapists, Enwemeka urged Nigeria to raise physiotherapy education to the level of Doctor of Physical Therapy (DPT) to meet the global standard of the profession. Enwemeka said: “The problem is a very serious one because people are living longer than in the past.
But people are living longer with technology and with the need for rehabilitation. In old age, people need a lot of help because they suffer from debilitating diseases and survive it. In the past, people do not survive stroke, diabetes, heart attack and complications of other terminal diseases. But today, people survive them because we have developed medicine to a very high level; we have developed technologies that enable people to survive. “However, they need long-term care; they need people to rehabilitate them and help them during the period of convalescence.
This is where physiotherapists and others in the field of rehabilitation come in. But the country does not have these experts who can handle it. So, if the medicine is effective, even if the surgery has taken care of what it is supposed to do successfully, the complications that are attendant to the surgery and being able to survive a terminal disease are such that the patient need long-term care and follow up. That is not happening. And as a result, the surgery that was otherwise successful now turns out to be a problem, because the person is not going to survive for a very long time.
“People live with diabetes for more than 60 years in developed countries; others survive post-stroke and heart attack for another 40 years, without any issue. That is because they have a long-time care and have people who are helping them with their needs to make them self-sufficient and independent. We do not have any of such people in the country. And the situation is getting worse because even childhood disability diseases that would have meant death sentence in the past for children, we can now take care of them with advanced medicine. But those children will need care for the rest of their lives, and they will need physiotherapists.
“One of the reasons people go abroad to get care is not necessarily because the surgery is not going to be successful, if they were to do it here. But because of post-surgical care that is needed, which has been developed to a very high level in developed countries, but which has been neglected in Nigeria, up to the point that it now appears as if the surgery was not successful.
“The reason why the surgery appears not to be successful is that the post-operative care, which physiotherapists and nurses will have to embark upon, has not been supported by the system, not just in term of the personnel, but in terms of resources and equipment people need to do their jobs, which they are already trained for. “There is also the issue of education, which needs to be raised to a higher standard. For example, the physiotherapist is trained up to doctoral level as a Doctor of Physical Therapy (DPT).
The Doctor of Physical Therapy is an advanced practitioner who can independently, for example, first hand do physical therapy diagnosis. The patient can wake up to go and see a physical therapist, if he has any problem he thinks has the need for that. If it is not the business of the physiotherapist, he will refer the patient to a physician. And if it is the line of his business, he will embark on treatment.”