The Practice of Physical Medicine and Rehabilitation in subSaharan Africa and Antarctica: A White Paper or a Black Mark?

Objective: The medical specialty of physical medicine and rehabilitation (PM&R) has had a proven impact on persons with disability and on health care systems. Documents such as The White Book on Physical and Rehabilitation Medicine in Europe have been important in defining the scope of practice within various regions. However, on some continents, the practice has not been well defined. Design: To explore the practice of PM&R in subSaharan Africa and Antarctica. Methods: Medline searches, membership data searches, fax survey of medical schools, Internet searches, and interviews with experts. Results: The continents are dissimilar in terms of climate and government. However both Antarctica and subSaharan Africa have no PM&R training programs, no professional organizations, no specialty board requirements, and no practicing physicians in the field. Because there are no known disabled children on Antarctica and adults are airlifted to world-class health care, the consequences of this deficit are minimal there. However, the 788,000,000 permanent residents of subSaharan Africa, including approximately 78 million persons with disability, are left unserved. Conclusions: Antarctica is doing fine. Africa is in a crisis. Local medical schools, hospitals doctors, and persons with disability; along with foreign volunteers, aid groups, and policymakers can impact the crisis. However government—specifically national ministries of health—is ultimately responsible for the health and wellbeing of citizens. [Copyright &y& Elsevier]