In today's increasingly interconnected world, the call for inclusivity reverberates louder than ever before. It is a fundamental human right to live in a society where everyone, regardless of ability, has equal access to opportunities and resources. Yet, for persons with disabilities, this vision of inclusivity often remains elusive, hindered by barriers both physical and societal. However, amidst these challenges, there shines a beacon of hope: the transformative power of rehabilitation and assistive technology education and integration.
World Health Organization (WHO) defines rehabilitation as "a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment."
In Pakistan, to raise awareness on this subject and to sensitize the government and private sector, a project called the Learning Acting and Building for Rehabilitation in Health Systems (ReLAB-HS) is working at both national and provincial level. Under this project, it was the first time ever that in Pakistan, the Global Rehabilitation Leadership Institute organised a leadership training course in Pakistan. Conducted by Johns Hopkins University of the USA, the course was attended by rehabilitation professionals, students, doctors, academicians and media persons. The purpose was to raise awareness about the importance of rehabilitation and assistive technology at different levels to create and work towards an inclusive society.
The Global Rehabilitation Leadership Institute (GRLI) aims to equip and empower professionals across all disciplines and levels of the health system to translate technical know-how into effective, implementable programs and policies that strengthen health systems and elevate rehabilitation and assistive technology services across low- and middle-income countries.
According to one of the alumni of the course, Ms Neelum Zehra Bukhari, Country Focal Person Physiopedia at ReLAB-HS, there are 31 disciplines working under the directives of Pakistan Council of Allied Health Professionals out of these six disciplines are related to rehabilitation. Education in all these disciplines is available at undergraduate level, but post-graduation education isn't available except for physical therapy due to unavailability of PhD faculty at that level and also due to the stringent criteria devised by Higher Education Commission (HEC) for post graduate education.
In order to have competent workforce, ReLAB-HS aims to build capacity at academics, regulation and clinical skill level through International Rehabilitation training toolkit implementation with the partnership of Physiopedia in the activity. The program reflection assessment toolkit of IRETT has enrolled major programs at two of the provinces as pilot projects to evaluate the gaps and strategies at institutional level for bringing these gaps for global standard education in rehabilitation.
She stresses the need for a collaboration among HEC, AHPC and IRETT for producing competent and skilled professionals, who can deliver the rehabilitation services as per the global standards in Pakistan.
It's a high time for local stakeholders to join hands for collaboration and utilise the resources or IRETT for the capacity building of rehabilitation workforce. There is need that through IRETT activity national curriculum is deigned keeping the local context in mind. Moreover, it should also provide a component of continuous professional development which involve upgradation of current practicing professional skills to meet the pace of advancement in rehabilitation discipline.
According to the latest figures released by the World Health Organization, in April 2024, globally, an estimated 2.4 billion people are currently living with a health condition that may benefit from rehabilitation, while it has predicted an increase in the need for rehabilitation worldwide due to changes in the health and characteristics of the population. For example, people are living longer, but with more chronic disease and disability.
Currently, the need for rehabilitation is largely unmet. In some low- and middle-income countries, more than 50% of people do not receive the rehabilitation services they require. Emergencies including conflicts, disasters and outbreaks create enormous surges in rehabilitation needs while also disrupting rehabilitation services.
The Human Rights Watch estimates the number of people living with disabilities in Pakistan wildly vary from 3.3 million to 27 million. So there is a surge in the need for rehabilitation and AT in the past few years.
Unlike the traditional thinking that these services are only required by adult population, the statistics reveal that in the academic environment too, the students need these services. By equipping students and professionals with the necessary knowledge, education, skills and tools, rehabilitation and assistive technology pave the way for a more inclusive and accessible world.
Through specialized training in disciplines such as physical therapy, occupational therapy, and speech therapy, rehabilitation professionals learn techniques and interventions aimed at improving mobility, enhancing motor skills, and promoting communication abilities. This restoration of functionality is crucial in enabling individuals to perform daily tasks, engage in meaningful activities, and participate fully in society.
Education in rehabilitation fuels innovation and drives advancements in the field. By training the next generation of rehabilitation professionals, educators inspire creativity and critical thinking, encouraging students to explore new approaches and technologies to improve outcomes for individuals with disabilities.
In the same manner, assistive technology education is essential to ensuring that individuals with disabilities can fully harness the potential of these tools. Here are some examples of assistive technologies needed at the academic level:
1. Screen Readers: Screen readers are software programs that convert text on a computer screen into synthesized speech or Braille output. They enable individuals with visual impairments to access digital content, including textbooks, websites, and educational materials.
2. Text-to-Speech Software: Text-to-speech (TTS) software converts written text into spoken words. This technology is beneficial for individuals with dyslexia, learning disabilities, or other reading difficulties, as it can help them comprehend written material more effectively.
3. Speech Recognition Software: Speech recognition software allows users to dictate text and control computer applications using their voice. This technology is valuable for individuals with physical disabilities or those who have difficulty typing, enabling them to interact with computers and complete academic tasks more independently.
4. Alternative Keyboards and Mice: Alternative keyboards and mice are designed to accommodate individuals with physical disabilities or mobility impairments.
5. Augmentative and Alternative Communication (AAC) Devices: AAC devices are designed to assist individuals with communication impairments, such as nonverbal individuals or those with speech disorders. These devices range from simple picture boards to sophisticated speech-generating devices that allow users to express themselves using symbols, text, or synthesized speech.
6. Braille Displays and Embossers: Braille displays and embossers translate digital text into Braille output, enabling individuals with visual impairments to access written information tactilely. These devices are essential for students who are proficient in Braille or who are learning Braille as a literacy skill.
7. Accessible Learning Management Systems (LMS): Learning management systems should be designed with accessibility features to ensure that students with disabilities can navigate course materials, participate in online discussions, and complete assignments. This may include features such as keyboard navigation, compatibility with screen readers, and support for alternative formats.
8. Captioning and Transcription Services: Captioning and transcription services are essential for individuals who are deaf or hard of hearing, ensuring access to audiovisual content such as lectures, videos, and multimedia presentations. Real-time captioning and transcription can facilitate communication in classroom settings and during online learning activities.
By integrating these assistive technologies into academic environments, educational institutions can promote inclusivity and support the diverse needs of students with disabilities. Telerehabilitation could be another strategy to fill the gap caused by a rehabilitation staff shortage.
Rehabilitation is an important part of universal health coverage and is a key strategy for achieving Sustainable Development Goal 3 - "Ensure healthy lives and promote well-being for all at all ages."
By empowering individuals to overcome physical limitations, promoting mental and emotional well-being, facilitating access to assistive technology, and fostering a culture of inclusivity, these fields serve as catalysts for positive change. As we strive towards a more equitable and accessible society, investing in rehabilitation and assistive technology education is not just a moral imperative but a pathway to a brighter and more inclusive future for all.