Rehabilitation after the Sichuan earthquake: Can we follow the way?

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This summer, I went to Sichuan thrice. On each occasion, I found myself near tears as I treated limbless children who had had their arms and legs amputated by surgeons so that the children could be rescued from the rubble. At 2:28 p.m. on 12 May 2008, the ground shook and thousands of buildings swayed and collapsed. Bricks, debris, twisted metal and slabs of concrete were everywhere. The earthquake also destroyed tens of thousands of homes. The magnitude 8 Wenchuan earthquake in Sichuan is China's worst natural disaster since the 1976 quake in Tangshan. Counties like Wenchuan and Dujiangyan, and cities like Mianzhu, Deyang and Shifang were the most affected areas. According to latest official govern-ment sources, more than 69,000 people died, 220,100 were injured, about 18,000 are listed as missing, 4.8 million people have been rendered homeless, and 15 million displaced. Many school children were amongst those tragically killed and injured when their school buildings collapsed. The Chinese government estimates that over 7,000 schoolrooms collapsed in the earthquake. Rescue workers dug through the debris looking for their children. Over 6 months have passed and nearly all the quake victims are stilling living in tents and temporary houses, which provide shelter for them to survive in the 40°C hot summer and the coming cold winter and snows. Although the most critical period of rescue is over, there remain many pressing issues: 1. There is a great need for orthopaedic and neurological rehabilitation of victims who have suffered from amputation, fracture, spinal cord injury and traumatic brain injury. Those with spinal cord injury and brain injury, who were sent to different provinces for treatment and rehabilitation after the earthquake, are still living in hospitals. There is an urgent need for resettlement after subacute rehabilitation in the coming few months. As most of the patients are young, the sustainability of community, vocational and psychosocial rehabilitation will be critical. Continuous rehabilitation for those with learning difficulties should be of the highest priority. 2. Plans to support further reconstruction of homes, schools and rehabilitation centres are of the utmost importance. The newly built schools must be able to provide a physical environment that is accessible to and usable by students with severe physical disabilities. In addition, thousands of parents around the province have accused local officials and builders of cutting corners in school construction, citing that after the quake, nearby buildings were little damaged. In future, it is not only important to ensure that the construction standards for primary and middle schools in rural areas are improved, but money should also be used to strengthen the concrete structure of school buildings so that they will be able to withstand future earthquakes. 3. There are many children of all ages who lost their parents in the quake, or whose parents have been so injured that they are unable to take care of their children. Many children, parents, and teachers who lost their families and students need counseling. There are huge needs for community re-integration training programs for families, continuing education for students, self-help networks and life planning for these persons. While rehabilitation is under way, there is a shortage of occupational therapists for the work that needs to be done. It is estimated that there are fewer than 100 qualified occupational therapists in China at present. This severe staff shortage is due to the lack of professional occupational therapist educators in China who are qualified to provide professional training. As a result of the lack of training opportunities, the development of occupational therapy (OT) services in China has been relatively slow in the past 20 years (Zhuo, 2006). Moreover, while occupational therapists potentially have much to contribute in facilitating the recovery of traumatized people and communities, they are not generally connected into formal disaster response mechanisms (World Federation of Occupational Therapists, 2006). Jointly operated with the Deyang Disabled Persons' Federation, the Hong Kong Red Cross has established a model rehabilita-tion site in Deyang city, Sichuan. The Deyang Disabled Person's Federation, Hong Kong Red Cross Rehabilitation, Prosthetic and Orthotic Centre (The Centre) opened officially on 3 November 2008 after being in service for 4 months. The Centre is the first rehabilitation, prosthetic and orthotic institute which provides free-of-charge prosthesis installment and comprehensive rehabilitation to communities affected by the earthquake. With support from the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, to provide professional consultation, and equipment and environmental set-up, it is hoped that The Centre will be able to provide full-capacity physiotherapy and OT services by employing full-time physiotherapists and Letter from the Editor occupational therapists, to serve earthquake patients following acute management of amputation, that is equivalent to the standard of provision in Hong Kong. Therapy will be provided before and after prostheses fitting by expert prosthetists and orthotists from Hong Kong. Another important mission of The Centre is to serve as a mainland clinical education centre for nurturing both physiotherapy and OT students in their clinical placements. The role of OT in The Centre is also important in the assessment of the long-term needs and real living environment of patients in order to achieve the goal of their being able to live independently. There are plans to set up an ambulatory team to earthquake sites near Deyang city and to remote rehabilitation units in villages and schools. Vocational preparation, in the form of community enterprises, may be able to address the growing need for employment options for amputees with mild to moderate disabilities. As the demand for OT services is very great, many charitable organi-zations welcome occupational therapists who would like to volunteer their services on a regular basis in Sichuan. For many years, I have not seen such a slogan appear in China everywhere as it does now, " When love comes to the land, life will be there till the end () " . While earthquakes cannot be prevented, proper rehabilitation can help people survive these natural disasters.




Fong, K. (2008). Rehabilitation after the Sichuan earthquake: Can we follow the way? Hong Kong Journal of Occupational Therapy. Elsevier (Singapore) Pte Ltd.

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