THE PRACTICE OF PHYSICAL AND REHABILITATION MEDICINE IN SUB-SAHARAN AFRICA AND ANTARCTICA: A WHITE PAPER OR A BLACK MARK?

Introduction: The medical specialty of physical and rehabilitation medicine has had a proven impact on people with disabilities and on healthcare systems. Documents such as the White Book on Physical and Rehabilitation Medicine in Europe have been important in defining the scope of practice within various regions. However, in some regions the practice has not been well defined. Objective: To explore the practice of physical and rehabilitation medicine in Sub-Saharan Africa and Antarctica. Methods: Medline searches, membership data searches, fax survey of medical schools, internet searches, and interviews with experts. Results:The continents are dissimilar in terms of climate and government. However, both Antarctica and Sub-Saharan Africa have no physical and rehabilitation medicine training programs, no professional organizations, no specialty board requirements, and no practising physicians in the field. Since there are no known disabled children on Antarctica and adults are air-lifted to world-class healthcare, the consequences of this deficit are minimal there. However, the 788,000,000 permanent residents of Sub-Saharan Africa, including approximately 78 million people with disabilities, are left unserved. Conclusion: Antarctica is doing fine, but Africa is in a crisis. Local medical schools, hospitals doctors, and people with disabilities, along with foreign volunteers, aid groups, and policymakers can have an impact on the crisis. However, governments, specifically national ministries of health, are ultimately responsible for the health and well-being of their citizens.