Contrasting Fortunes in ‘paradise’ Mauritius between acute care and neuro-rehabilitation
Soopramanien, Jamwal, Paddison S
Consultant in Spinal Injuries
Consultant in Spinal Injuries Royal Bucks Hospital, Aylesbury (UK) and Centre of Postgraduate Medical Research and Education (Bournemouth, UK)
Head Occupational Therapist
Head Occupational Therapist, Royal Bucks Hospital Aylesbury (UK)
Superintendent Physiotherapist, London Spinal Injuries Centre (UK) 1, 2, 3
NEURAM FOUNDATION Neuram.org (Mauritius)
MAURITIUS is a strong economy in Africa
- Per capita GDP grew from $200 in 1968 to over $7,700 today 4.
- GDP grew by an annual average of 5.1% between 1977 and 2009.
- It ranks 25th out of 190 global economies in the World Bank’s Doing Business 2016 paper. Mauritius.
- Ranks 1st amongst African countries on the Global Competitiveness Index and the 2015 Index of Economic Freedom.
It prides itself on not having tropical diseases; but there is a rise in non-communicable diseases
- Obesity 4 : 52.4 % of population are overweight or obese
- Hypertension: 28.4 % of population (27.6% women, 30.3 % men)
- Diabetes in 20- 74 years: 257,442 people or 20.5% of population
- Cardiovascular diseases: 2013 6: 31% of deceased persons suffered from heart problems. (there were 1143 deaths from Ischaemic Heart Diseases 2016 6)
- Strokes: 3000 individuals are affected by stroke each year (748 deaths in 2016 6)
- Severe, catastrophic Injuries from Road Traffic Accidents: 500 cases each year.
Issues to be addressed
- High incidence of Pressure Ulcers
- Bladder: 90 % of patients only had indwelling urethral catheters.
- Bowels: incontinence pads.
- Wheelchair: bulky, no removable armrests, no cushion
- Psychology: no support to patients or families
- Poor Manual Handling: no equipment, no training.
Government’s focus has been to develop acute services
- Neuro Surgery
- Spinal Surgery
- Cardiothoracic Surgery
Initiatives so far
Government is also working on prevention strategies
- Health Education
- Prevention of accidents (campaign on ‘coaltar’)
- Healthy Eating
- Campaign on Safer driving
What is lacking is Structured Rehabilitation
- No rehab bed on the island
- Consultants in Rehabilitation Medicine are rheumatologists; none is trained in neurological rehabiliitation.
- There is no multidisciplinary input.
What NEURAM proposes to do
- Peer support
- Training of community neuro-rehabilitation workers, patients, families and carers (face-to-face; e-learning)
- Educational programmes on: Prevention of accidents
- Prevention and treatment of medical complications (pressure ulcers, continence).
- Manual handling & Transfers
- Aids and equipment.
- Principles of house adaptations.
- Other topics as identified by specialists
- Bridge the gap between acute care and community support
- Set up Outreach Clinics and Mobile Facilities to bring neuro-rehabilitation near patients’ home
- Set up a Neuro-rehabilitation centre in Mauritius in one or two sites – as circled in map
- With support from stakeholders, national and international.
4. Jean-Claude Bastos de Mofais- Founder and Chairman of the Advisory Board- Quantum Global Group- World Economic Forum – 19 July 2016.
5. Baker IDI (Australia) and Ministry of Health and Quality of Life (Mauritius)- The Mauritius Non-communicable diseases Survey 2015- Trends in diabetes and cardiovascular risk in Mauritius
6. Ministry of Health and Quality of Life- Health Statistics Report 2016- A publication of the Health Statistics Unit.