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This report has two main aims: to highlight the need for physical therapist involvement in disaster management and particularly in Emergency Medical Teams (EMTs); and to brief physical therapists who want to work in the field, and national and international agencies who are already working in the field. Following an introduction to the topic of disasters, the paper outlines in separate sections the three phases of disaster management most relevant to physical therapists: preparedness; response; and recovery. Each section includes information on the role of physical therapists and details guidelines and resources to support practice in disaster management. Case studies include: Nepal, 2015 April earthquake; 2011- great East Japan earthquake; integration of rehabilitation professionals into the UK Emergency Medical Team; Nepal, 2011 onwards; Phillipines, typhoon Sendong, 2011;  Phillipines, typhoon Haiyan, November 2013; Haiti, 2011- physical therapy in post-earthquake recovery and reconstruction; Pakistan, earthquake Oct 2005; Phillipines, typhoon Bopha 2012-2013.

The role of rehabilitation professionals in responding to Sudden Onset Disasters (SODs) is evolving rapidly, and our professions increasingly find themselves at the forefront of emergency response teams. At the same time, there is a movement towards the professionalisation of the humanitarian response sector, in particular Emergency Medical Teams, and a recognition that specialist training is required to prepare professionals for work in an austere humanitarian environment. The intended audience of the manual are physiotherapists and occupational therapists who may deploy to provide rehabilitation in the immediate aftermath of a sudden onset disaster. It was developed to support volunteers on the UK International Emergency Trauma Register (UKIETR), but with the aim of being relevant to all rehabilitation professionals interested in rapid deployment to austere environments. The content is restricted to the context of sudden onset disasters such as an earthquake or tsunami, and has been developed to support work in an austere environment, where the type of equipment and support that is normally available has been disrupted. UKIETR professionals are UK based volunteers who receive specialist training to prepare them for international deployment as part of team in response to emergencies. They may be deployed within a multi-disciplinary foreign medical team in a field hospital scenario, or as part of a more specialist ‘cell’ offering niche medical, surgical or rehabilitation services. The manual is designed to complement the three day core rehabilitation training run by Handicap International which all UKIETR members must attend. It is a clinical manual, and the contents are directly linked to modules taught on the core training course. In addition there are a number of ‘cheat sheets’ and patient education resources at the back of the manual which are designed to be used in the field. Chapters include: rehabilitation and the UKIETR; introduction to rehabilitation following sudden onset disasters; amputee rehabilitation; spinal cord injury; peripheral nerve injury; fractures; burns and soft tissue injury; and acquired brain injury

Background: There seems to be a paucity of research on the initial subjective experiences of family caregivers of survivors of a traumatic brain injury (TBI).

Objective: To explore the challenges that family caregivers face during the initial stages of recovery of a relative who has sustained a TBI.

Methods: Thematic analysis was used to explore the findings from semi-structured interviews that were conducted with 12 female family caregivers of relatives who had sustained a TBI.

Results: Family caregivers recalled their initial experiences of the shock at hearing the news about their relative’s TBI, negative experiences in hospital and frustrating interactions with healthcare professionals as particularly challenging. 

Conclusion: The findings of this study emphasise caregivers’ need for support, information and psycho-education, especially from healthcare professionals, from the very beginning stages of recovery from a TBI. Practical and physical needs with regard to admission to and care in the hospital were also highlighted. This research will hopefully contribute to creating awareness amongst healthcare professionals on how they can contribute to improvement of the services provided by the healthcare system based on the experiences of the caregivers who participated in this study.

Details are given of the use of explosive weapons in Syria since 2011 and its effects on the population highlighted. The density of explosive weapons use (2013 - 2015) in Syria is mapped and the numbers of affected population by Syrian governorate are provided. Between December 2012 and March 2015, 77,645 incidents were recorded following conventional weapons and IEDs use in Syria. Explosive weapons represent 83.73% of recorded incidents and the distribution of type of weapons use per rural and urban areas is given. The higher risk of developing permanent impairments by people injured by explosive weapons and the long-term impact of explosive remnants of war on services and infrastructure are highlighted.

This Guidance Note provides DFID staff with an overview of how to ensure the needs of older persons and people with disabilities, including people with injuries and chronic diseases, are addressed in humanitarian response

Purpose: This article explores the reproductive wants and needs of persons with spinal cord injuries (SCI), along with factors that influence these needs and the services available to them.

Method: The study sample comprised persons with SCI from China Rehabilitation Research Centre who matched the research criteria and consented to participate. Data collection took place through questionnaires and in-depth interviews. After the objectives, contents and methods of the survey were explained, 63 respondents answered the questionnaire, and 17 of them (15 men and 2 women) agreed to participate in the in-depth interviews. All the respondents were above 18 years of age, either unmarried or married, and childless.

Results: It was found that 85.7% of the respondents wished to have children. The more severe the SCI, the less was the desire for children. Those with higher levels of education were less inclined to have children. While financial situation had little impact on the wish for children, the impact of traditional concepts was significant. The reproductive experiences of other SCI clients had a significant influence on respondents’ desire to have children. More than 50% of the respondents were ignorant that they could have babies after SCI. 96.8% of them believed that a child played an important role in marital stability. Though 54% of the respondents wished to have their sexual and fertility problems addressed in medical and rehabilitation institutions, 93.7% said they had not received any such professional services during the previous year.

Conclusions: Although most persons with spinal cord injuries are very keen to have children, their wants and needs are not recognised and little attention is paid to specialized service provision to address their needs. This study suggests that steps such as improving awareness, disseminating knowledge and setting up institutions to provide professional services are necessary to address reproductive needs and to protect the reproductive rights of persons with SCI.

The aim of this paper is to provide a snapshot of the types of injuries caused by explosive weapons, such as those encountered by Handicap International (HI) while working with Internally Displaced Persons (IDPs) in Syria

Purpose: The study aimed to explore the outcome of current practices in the treatment of persons with traumatic spinal cord injuries (TSCI) in Bangladesh, through the stages of rescue and first contact with physician, transportation to the tertiary hospital and intermediate admission.

Method: This observational study was conducted between June and August 2011, at the Centre for the Rehabilitation of the Paralysed (CRP), in Dhaka, Bangladesh. From the 113 persons with SCI admitted at CRP during this period, 56 persons with TSCI were selected. With the help of a questionnaire, data were collected from these persons or their attendants by trained staff, and also taken from hospital records. Data were processed and analysed by SPSS software version 16.

Results: The male-female ratio among the study participants was 5.25: 1, with a mean age of 33.02 years. 55.3% of them were paraplegic, while 44.7% were tetraplegic. About 70% of the injuries were complete according to ASIA impairment scale (AIS) during admission at CRP.

The most common causes of injury were falls (50%), followed by road traffic accidents (RTA) and carrying loads on the head. 74.8% of the injured persons had been rescued from the accident site by local people but only 16.1% had been transported by ambulance. The spine board had never been used. More than half of the injured received initial treatment only at a sub-district or district hospital where none of the requisite facilities were available.

While being transported from one hospital to the other, 10.7% experienced neurological deterioration of some sort. Significant statistical correlation was found between mode of transfer (P <0.03) and intermediate admission (P<0.001)with neurological deterioration.

Conclusions: There is an urgent need to implement pre-hospital trauma care in Bangladesh. Since resources and places for the rehabilitation of persons with TSCI are scarce, regional and national spinal injury centres should be established without delay.

Limitations: The study focussed only on a small sample of persons with TSCI undergoing treatment at a single centre.

"This policy brief focuses on the gender dimension of small ‘p’ priority-setting for land release. Preferences identified through consultation with stakeholders from different gender, age and socio-economic groups should lead to the allocation of resources to, and concentration of activities on, tasks where impact will be the greatest"
GICHD policy brief 5