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 healthcare 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. The aim of this paper was 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. Since 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.
Department of Physical Medicine and Rehabilitation, The University of Michigan Ann Arbor, MI Haji , USA. andyhaig@umich.edu
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Adewole
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Nelson
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D017954:Africa South of the Sahara; D000864:Antarctic Regions; D003695:Delivery of Health Care / Q000458:organization & administration; D006233:Persons with Disabilities / Q000534:rehabilitation*; D019538:Health Care Surveys; D006291:Health Policy; D054625:Healthcare Disparities; D006801:Humans; D007391:International Cooperation; D010810:Physical and Rehabilitation Medicine / Q000193:education / Q000379:methods* / Q000458:organization & administration; D012577:Schools, Medical; D013038:Specialization / Q000706:statistics & numerical data; D000078329:Workforce