Spinalis in Botswana
Spinalis Botswana Spinal Cord Injury Rehab Project is a three-year partnership between the Botswana Ministry of Health (MoH) and the Spinalis Foundation in Sweden. The project is part financed by the Swedish International Development Cooperation Agency (Sida). The aim of the project is to build capacity for comprehensive spinal cord injury (SCI) rehabilitation within the Botswana Public Health Care Services.
Basic public health care is comparatively well developed in Botswana but the knowledge and the resources for rehabilitation of persons living with SCI are very limited. Persons living with SCI in Botswana, whom are lacking insurance coverage, are not given any proper rehabilitation nor any relevant technical aids. Persons with insurance coverage (mainly victims of road traffic accidents) could get limited rehabilitation in South Africa as well as be given basic technical aids. The MoH acknowledges this situation and in 2009 Spinalis was asked to set up a SCI rehabilitation project at Botswana’s largest public referral hospital, Princess Marina Hospital (PMH) in Gaborone, the capital of Botswana.
The clinical phase of the project started in April 2010 and was located to the orthopaedic ward at the PMH. A very limited number of local staff, one physiotherapist, one occupational therapist, one nurse and a part time medical doctor, was assigned to the project. The Swedish team consisted of one physiotherapist/project coordinator on site full time and one physiotherapist, one occupational therapist, one nurse, two medical doctors and a project director on site for longer or shorter periods.
The challenges during the first year were tough and multiple. Patients were kept in their beds most of the time with no real program for rehabilitation. Care was insufficient, bedsores frequent and patients that could eventually be discharged were often discharged without the relevant technical aids.
In spite of all the challenges the project made fast progress thanks to a dedicated team. Through support from the MoH and the PMH the local staff could be reinforced for more relevant care and rehabilitation.
In March of 2011 the project advanced to a stage were it became possible to upgrade the resources and in July of 2011 a SCI rehab centre could be opened.
Although the project were well ahead of the plan, the challenges for the second year were considerable; the quality of care had to be further increased, staff training intensified, guidelines implemented and a sustainable supply chain for equipment, consumables and technical aids to be developedt. Most important, the long-term resources for the centre within the Botswana public health care services had to be secured.
The Spinalis Foundation will support Spinalis Botswana SCI Rehab Centre beyond the three-year project period.
Lisa Bergmark, Occupational therapist
Tobias Holmlund, Physiotherapist
Claes Hultling, MD
Göran Lagerström, Project leader
Gunnel Lif, Nurse
Inka Löfvenmark, Physiotherapist, project coordinator in Botswana
Erika Nilsson, Project coordinator in Stockholm
Katarzyna Trok, MD
Pelle Vesterlund, Rehab coach