Mozambique

According to the Landmine Survivors database, while there seems to be a number of rehabilitation centers available, it appears that many are underutilized due in part to a lack of transport for the clients, lack of patient education on the benefits of long term physical therapy interventions, lack of immediate results and the time and energy it requires to come regularly for sessions. Further, “In Zambezi province, Landmine Survivors Network (LSN) conducts home and hospital visits to assess the individual needs of landmine survivors and other persons who have experienced limb loss. LSN provides peer counseling, referral to services and direct support as needed.”

According to some estimates, phantom limb sensations are experienced by as many as 80% of amputees (Melzack, 1992) ; it is reported to be accompanied in more than half of the cases, by excruciating and chronic pain (Flor, 2002a; Koojiman, Dijkstra, Geertzen, Elzinger, & van der Shan, 2000).

WHO reports that almost all developing countries have some rehabilitation services, but that such services generally reach less than 5% of the people with disabilities in the community. These services are frequently based in hospitals in centralized urban areas, which results in prohibitive costs and limited accessibility for the general population. In response, WHO recommended the integration of rehabilitation services into community-based primary health care systems (Meier RH 3rd,Smith WK).

Optimal psychophysical re-integration and physical rehabilitation is paramount for those suffering from the pain and emotional challenges associated with limb loss in order to fully reintegrate into society. The Trager® Approach to Movement Education, provides an effective, pleasurable and relaxed state dependent learning model ideal for addressing such acute psychophysical trauma where painful and extensive functional limitation may be present.

Following our successful protocol initiated in Sri Lanka, the program’s intent is to educate Physical Therapists in progressive, lasting approaches to releasing dysfunctional, compensatory muscle patterns and for relieving Post Traumatic Stress associated with Phantom Limb Pain and acute psycho-physical trauma. Clinical participation will also serve as the demonstrative training component of the program.

Therapists will be instructed in self care protocols essential for their own well being and when possible, training in fundamental yet effective methods for relieving muscular and tension related pain will be provided to Lay Care givers. This latter program is perhaps the most important component to the trainings. Educating lay care givers in local communities in basic healing touch will not only increase the accessibility to basic rehabilitation services for these individuals, but may also bridge the gap in understanding the benefits of physical therapy and related treatment protocols for relieving pain and improving the quality of life.