Rehabilitation services in disaster response

Perspectives The United Nations Convention on the Rights of Persons with Disabilities has firmly placed disability in a human rights perspective. In the context of the Convention, disability refers to activity limitations and participation restrictions that result from the interaction of an impairment of body function or structure with environmental factors. The Convention addresses the rights of persons with disability in all aspects of life, including education and community integration and their right to equal access to services, such as schools, medical facilities and communication. Articles 25 and 26 explicitly state the right to health and access to health-related rehabilitation for persons with disabilities, 1 in all settings and situations , including during emergencies and natural disasters. Adherence to the Convention however, can be particularly challenging in a disaster response given the different economic and social vulnerabilities including poverty, as well as environmental hazards and damaged infrastructure. This can be further compounded by the limited time emergency medical teams are typically deployed for as part of a disaster response. Often when disasters occur in low-and middle-income countries, there is an influx of specialist health workers from high-income countries. In affected countries where health systems are weak, and health-related rehabilitation services are not a priority, this influx of specialist health workers can result in individuals with certain types of traumatic injuries – such as spinal cord injuries, amputations, brain injuries or peripheral nerve injuries – surviving with long-term impairment and associated disability, in an environment with limited capacity to address their ongoing needs. 4 Until recently, rehabilitation professionals have been underrepresented in emergency medical teams. In recent years however, guidance documents have started to promote the importance of inclusion and/or close coordination of rehabilitation professionals with these teams. Inclusion of rehabilitation personnel in emergency medical teams indicates a trend towards patient-centred care and offers timely access to rehabilitation intervention to those who have sustained injuries, which has been found to prevent complications, speed recovery and optimize functional outcomes for the injured. 2,3 Rehabilitation personnel in emergency medical teams are also well placed to provide mentor-ship and support local staff to manage the surge of individuals with traumatic injuries and the ongoing care needs of those affected. Historically, a medical model –where a person's impairment is perceived to be the problem, and the focus is on fixing the problem – has dominated emergency medical teams. However, the Convention with its focus on …