Physiotherapy in Nepal – A view from an external eye
I am currently in the midst of spending 3 weeks in the Physiotherapy Department of the Dhulikel Hospital and Kathmandu University School of Medical Sciences. Although there have been physiotherapists living and working in Nepal for a number of years I would have to say that physiotherapy as a profession is very much in it’s infancy in Nepal. In the past there have been some Certificate of Physiotherapy courses on offer but the Bachelor of Physiotherapy program here has only been running since 2010. This is the only place in Nepal where you can study physiotherapy. The very first cohort, consisting of 13 physios who previously had a Certificate in Physiotherapy, had their graduation ceremony while I was here. The second cohort of 12 students, also with previous Certificate of Physiotherapy, are currently undergoing their six month internship at Dhulikel Hospital and will finish around May 2016. The first year class is now made up of 30 students.
The current Bachelor of Physiotherapy takes 4 and ½ years to complete with the last 6 months being an internship. The staff work between the Hospital and the University as it is really one institution. I see this as a great advantage as those who are teaching are also spending time working with patients and so do not lose touch with what it is like to be a clinical physiotherapist. The downside is that the lecturers become very busy people. One of the biggest strengths is the dedication and passion that is evident amongst the senior physiotherapists. They are dedicated to being the best they can be at their job and are passionate about raising the profile of physiotherapy in the country as a whole.
Some of the challenges facing the physiotherapy profession in Nepal are lack of understanding from other medical professionals as to the role and contribution of physiotherapists, lack of education on the benefits of physiotherapy, lack of easy access to medical care in general and physio in particular especially for Nepalese who live in remote areas, lack of funding to provide physiotherapy to those who do not have many resources themselves and also lack of government awareness to support the growth and role of physiotherapy in the country. This has been compounded by the current fuel crisis in Nepal which makes travel to a centre such as Dhulikel Hospital even more difficult for those in remote areas.
On the individual level there are also challenges to overcome. Rates of pay make it very difficult to access continuing education, which is often overseas. It is difficult to retain physiotherapists in Nepal when their role may not be well understood and so it can be difficult to get a job. With a marketable skill like physiotherapy it is very tempting to move to a developed country where there are more job opportunities, better pay and a better standard of living.
I would like to encourage all physiotherapists and physiotherapy students in Nepal to continue striving to develop the profession in Nepal. You can and do make a difference in people’s lives. It will take commitment and hard work. There will be frustrations and set-backs. The progress will be slower than you would like. By all means go to another country to study or learn from working in a different environment but always be aware of how you can contribute back to your own country. With the little I have seen of physiotherapy in Nepal I foresee a strong future for the profession. Keep going – the end result is well worth your time and efforts.
About the writer:
Neroli Page is an Australian Physiotherapist who has worked clinically and administratively in both Australia and the USA. Currently she is the Director of Physio2u NSW Pty Ltd which serves mainly a geriatric population in Aged Care Facilities and the community. In her spare time she enjoys travel, hiking, kayaking, reading and time with her family.