- Email: [email protected]
World Confederation for Physical Therapy
615
UPDATE
World Confederation for Physical Therapy Margaret 0 ’Hare Introduction A historical article about the World Confederation for Physical Therapy (WCPT) was published in the Centenary Journal (CSP, 1994). This paper is a n update account of the aims and aspirations in the future. The biggest and most exciting change within WCPT in recent years has been the regionalisation of the Confederation. Since 1991 the structure has been that of an international organisation operating out of five regions: Africa, Asia-Western Pacific (AWP), Europe, North America-Caribbean (NACR),and South America. Regionalisation was introduced to enable physical therapists in defined geographical areas to co-operate and work together to improve the status and standard of physical therapy within their region. There were many doubts: 0 Would
one region dominate? .Would costs of organising a regional structure in addition to the international network be prohibitive? @Wouldlanguage be a barrier? Would allegiance be divided between regional and international aims? It is fair to say that none of these doubts have been a brake on progress, and indeed regionalisation appears to have strengthened international solidarity. The first signs indicate that this strategy has been a great success. Maybe the only factor remaining to be resolved is financial - international and regional subscriptions can be hard to find in countries where physical therapists are not well paid. An evaluation of regionalisation is in hand and the results will be presented at the 13th General Meeting next year.
Physical Therapy or Physiotherapy Why is it the World Confederation for Physical Therapy (and not Physiotherapy)? The answer is simply that over forty years ago when the constitution was drafted, the North American terminology was used and the constitution was subsequently agreed by the founding members using this name. As readers can imagine, this terminology has been well debated over the years, alongside the further debate of whether the Confederation is for the profession - physical therapy; or the professionals - physical therapists. No doubt the debate will continue in the light of physiotherapy’s many synonyms worldwide - eg kinesitherapy.
Current Activities A long-term plan agreed in 1991 set the scene for current activities. The main goal was to implement and support regionalisation. This has now been completed successfully and in the future all major professional activity is expected to take place a t regional level, since
it is easier for members to communicate and to meet within a smaller geographic area. This premise has already been proved successful, in a very short time, by the success of three full-scale regional conferences in 1994 - in Europe on ‘Stroke management’, in Africa on ‘Physiotherapy for Africa’, and in Asia-Western Pacific on ‘Community-based rehabilitation’. The Confederation is still anxious, however, to ensure that some international activities are pan-regional. These can be divided into political and professional, the goal for both being to enhance the status and knowledge of physiotherapists worldwide.
Political This does not mean ‘party political’ but rather the means whereby physiotherapists can achieve and maintain the correct status within the health system of their country. Now that rationing of health care is so widespread, whether in developed or developing countries, the position of physiotherapists within health services has to be defended. To be able to do this, the health Ministers have to know what physiotherapists do and what the outcomes are. The Confederation, aware of this situation, is working on a set of internationally agreed Declarations of Principle and Position Statements. These will give physiotherapists negotiating with academic boards, with hospital managements and with health Ministers, a set of documents setting out the norms and expectations worldwide. The intention is to provide back-up for national physiotherapy associations but not to impose international standards. An ideology of internationally agreed standards for practice and education is not feasible or desirable - labelling, as it might do, some members as below standard and placing others in a position incapable of achieving it. The following are in draft and give some idea of breadth and scale of the issues being tackled under this ‘political’ heading: .Code of Ethics .Autonomy .Standards of Physical Therapy Practice .Protection of Title .Private Practice .Support Personnel for Physical Therapy Practice .Quality Care .Rights of the Patienuclient .Validation of Practice Techniques and Technology .Personnel Resource Planning .Relationships with Medical Practitioners .Relationships with Other Professions .Describing Physical Therapy OCurriculum Guidelines for entry-level physical therapy education
Physiotherapy, September 1994, vol80, no 9
616
Professional The international professional activities are planned to provide membership with help and guidance when planning future services and educational programmes. The most important event in this regard is the International Congress, held every four years. This helps physiotherapists get together to exchange experiences, learn from research findings, hear about future trends and hence plan their own future strategies within their own countries. (The 11th Congress as all readers will know was in London, the 12th will be in Washington in 1995, June 25-30.) Less may be known about the other activities under this heading. Over the last few years the Confederation has tried to help members worldwide plan services and education in two specific areas - care of older people and care of children with cerebral palsy, and to help members in private practice tackle the policy issues in their control.
Care of Older People In 1986 WCFT working with the World Health Organisation (WHO) funded research into elder care and in 1987 issued the first report (WCPT/WHO, 1989). This report provided guidelines for national associations planning care services for older people. One of its major recommendations was that training specific to elder care should be implemented in each country. The next step was for the Confederation to combined forces with the International Institute on Ageing (UNMalta) to plan how training might be planned. The work of an expert group, meeting in 1992, resulted in a second report specificalIy on curriculum building (WCF'T/INIA, 1992). The intention was that this curriculum should be tested among an international group who would not only evaluate its impact but would be able to implement similar or ancillary activities in their own countries. The test group of 33 students from 22 countries attended the first course in Malta in October 1993 and since then a number of initiatives have been put in place by the students in their own countries including surveys, reports, newsletters, contact groups and specialist seminars. At three regional meetings - NACR, AWP and Africa - students gave specialist seminars and at a seminar on elderly care organised by the Standing Liaison Committee of Physiotherapists in Europe, some
MISSM O'Hare and Pmfessor A J Fernando, secretary-general and president of the World Confederation for Physical Therapy
Physiotherapy, September 1994, vol80, no 9
students had the opportunity to present the Malta curriculum. The concept underlining all the activity described above is important - namely that the initiative at international level is intended to be seminal and that the important outcome is the subsidiary cascade initiatives a t national and regional level. The Confederation has been asked to organise a second international course, but the executive wants to be sure that this is a priority rather than another specialty care area.
Care of Children with Cerebral Palsy The intention and method were somewhat different with this initiative. During a visit by the executive to Africa in 1988, members indicated that one of the most intractable problems was the treatment of children with cerebral palsy in very rural settings where the visit of a physiotherapist is a luxury and a trip to the physiotherapy department of a hospital often impossible. Physiotherapists having to cope with the situation were few in number, and could not absent themselves for specialist training, but wanted help. The method of help devised was to get together a team. of tutors who devised a short course which they took from country to country in Africa as a 'travelling workshop'. This was so successful and appreciated, that W H O approached the Confederation with the idea of producing a manual for carers, whether professional mid-level workers or families, based on the workshop content. At first this idea was resisted a little, considering that a large number of very good published texts already gave guidance. However, finally convinced that a specific text was necessary, the Confederation again joined forces with WHO but this time also with the World Federation of Occupational Therapists to produce a text (WCPT/WFOT/WHO, 1993) which has been a runaway success and is currently being translated into other languages.
Private Practice Again a somewhat different approach was used to foster international debate on the issues faced by the fast growing community of private physiotherapy practitioners worldwide. In this instance the Confederation organised a n international four-day meeting of presentations, debates and round tables where various viewpoints on policy issues throughout the world could be compared. The intention was to consolidate private practice policy as much as possible at international level in order to help members in whose countries the ethos of private practice is not yet founded; and to help members working in countries with a well established private practice community but where legislation, insurance and other issues are not always favourable to physiotherapy. Those who attended this event have asked the Confederation to organise a second meeting and this may in fact result, but as with the idea of a second course on elder care, the Confederation wants to establish whether it might not be preferable to tackle other areas of physiotherapy concern worldwide.
617
The Confederation’s Gratitude to Executive Committee Members, Consultants, Tutors Someone has to plan, implement, evaluate and pay for the activities, and physiotherapists in all member countries are involved. To start with finance - although all costs are kept low thy funding for these projects comes from Confederation funds, managed by the Executive Committee. Member organisations contribute from the subscriptions paid to them by individuals in each country. But the vast debt of gratitude goes to all the ‘volunteers’ involved: .The Executive Committee members who are all assigned specific tasks (eg the position statements and declarations of principle were devised by a volunteer task force chaired by a committee member, as was the regionalisation evaluation task). .The consultants and tutors who gave their time to organise research, and conduct workshops or seminars, and who receive expenses only. This represents a huge commitment and contribution to the Confederation which could not be obtained any other way.
So What comes Next? Future activities which the Executive have in mind involve: .Further joint work with W H O and WFOT (the Confederation is committed to the concept that partnerships provide a better outcome). .An expanded publication programme - in addition to the Newsletter, plans are on the drawing board for a physiotherapy international terminology/dictionary and an international journal on professional (rather than clinical) issues. .Further international meetings, short courses and specific conferences, study visits, etc.
So please watch for news of these developments.
Confederation Data 54 members (national associations) 11 members elect (full membership to be ratified at the 13th General Meeting in Washington) 5 Regions Representing well over 200,000 physical therapists Executive Committee President - Prof A J Fernando Vice-president - M r David Teager Regional Members
Africa - Mr Geoffrey Moyo Asia, Western Pacific - M s Doreen Bauer Europe - Ms Pirkko Kuurne North America, Caribbean - M s Sally Edelsberg South America - M r Pedro Mancilla Secretariat Secretary General - Margaret O’Hare Executive Secretary - Cordelia Ohanian 4a Abbots Place, London NW6 4NP (tel 071-328 5448, fax 071-624 7579) Registered Charity No 234307.
References Chartered Society of Physiotherapy (1994). ‘Hands across the sea (and land)’, Physiotherapy, 80, A, 60A - 62A. Sutcliffe, B (ed)(1989).The Role of Physical Therapy in the Care of Elderly People, WCPTIWHO. Available from WCPT secretariat, f 20.
WhCPT/lnternational Institute on Ageing (UN-Malta)(1992).An Ageing World: Pysical implications and training strategies. Available from INIA, 117 St Paul’s Street, Valetta ULT 07, Malta,
Author
free. WCPTIWFOTNHO (1993).Promoting the Development of Young
Margaret O’Hare MSc has been secretarygeneral of WCPT since July 1986. She will retire on June 30, 1995, immediately after the Washington Congress.
Children with Cerebral Palsy: A guide for mid-level rehabilitation workers. Available from the Rehabilitation Unit, World Health Organisation, CH-1211, Geneva 27, Switzerland,one copy free.
~
Physiotherapy, September 1994, vol80, no 9
UPDATE
World Confederation for Physical Therapy Margaret 0 ’Hare Introduction A historical article about the World Confederation for Physical Therapy (WCPT) was published in the Centenary Journal (CSP, 1994). This paper is a n update account of the aims and aspirations in the future. The biggest and most exciting change within WCPT in recent years has been the regionalisation of the Confederation. Since 1991 the structure has been that of an international organisation operating out of five regions: Africa, Asia-Western Pacific (AWP), Europe, North America-Caribbean (NACR),and South America. Regionalisation was introduced to enable physical therapists in defined geographical areas to co-operate and work together to improve the status and standard of physical therapy within their region. There were many doubts: 0 Would
one region dominate? .Would costs of organising a regional structure in addition to the international network be prohibitive? @Wouldlanguage be a barrier? Would allegiance be divided between regional and international aims? It is fair to say that none of these doubts have been a brake on progress, and indeed regionalisation appears to have strengthened international solidarity. The first signs indicate that this strategy has been a great success. Maybe the only factor remaining to be resolved is financial - international and regional subscriptions can be hard to find in countries where physical therapists are not well paid. An evaluation of regionalisation is in hand and the results will be presented at the 13th General Meeting next year.
Physical Therapy or Physiotherapy Why is it the World Confederation for Physical Therapy (and not Physiotherapy)? The answer is simply that over forty years ago when the constitution was drafted, the North American terminology was used and the constitution was subsequently agreed by the founding members using this name. As readers can imagine, this terminology has been well debated over the years, alongside the further debate of whether the Confederation is for the profession - physical therapy; or the professionals - physical therapists. No doubt the debate will continue in the light of physiotherapy’s many synonyms worldwide - eg kinesitherapy.
Current Activities A long-term plan agreed in 1991 set the scene for current activities. The main goal was to implement and support regionalisation. This has now been completed successfully and in the future all major professional activity is expected to take place a t regional level, since
it is easier for members to communicate and to meet within a smaller geographic area. This premise has already been proved successful, in a very short time, by the success of three full-scale regional conferences in 1994 - in Europe on ‘Stroke management’, in Africa on ‘Physiotherapy for Africa’, and in Asia-Western Pacific on ‘Community-based rehabilitation’. The Confederation is still anxious, however, to ensure that some international activities are pan-regional. These can be divided into political and professional, the goal for both being to enhance the status and knowledge of physiotherapists worldwide.
Political This does not mean ‘party political’ but rather the means whereby physiotherapists can achieve and maintain the correct status within the health system of their country. Now that rationing of health care is so widespread, whether in developed or developing countries, the position of physiotherapists within health services has to be defended. To be able to do this, the health Ministers have to know what physiotherapists do and what the outcomes are. The Confederation, aware of this situation, is working on a set of internationally agreed Declarations of Principle and Position Statements. These will give physiotherapists negotiating with academic boards, with hospital managements and with health Ministers, a set of documents setting out the norms and expectations worldwide. The intention is to provide back-up for national physiotherapy associations but not to impose international standards. An ideology of internationally agreed standards for practice and education is not feasible or desirable - labelling, as it might do, some members as below standard and placing others in a position incapable of achieving it. The following are in draft and give some idea of breadth and scale of the issues being tackled under this ‘political’ heading: .Code of Ethics .Autonomy .Standards of Physical Therapy Practice .Protection of Title .Private Practice .Support Personnel for Physical Therapy Practice .Quality Care .Rights of the Patienuclient .Validation of Practice Techniques and Technology .Personnel Resource Planning .Relationships with Medical Practitioners .Relationships with Other Professions .Describing Physical Therapy OCurriculum Guidelines for entry-level physical therapy education
Physiotherapy, September 1994, vol80, no 9
616
Professional The international professional activities are planned to provide membership with help and guidance when planning future services and educational programmes. The most important event in this regard is the International Congress, held every four years. This helps physiotherapists get together to exchange experiences, learn from research findings, hear about future trends and hence plan their own future strategies within their own countries. (The 11th Congress as all readers will know was in London, the 12th will be in Washington in 1995, June 25-30.) Less may be known about the other activities under this heading. Over the last few years the Confederation has tried to help members worldwide plan services and education in two specific areas - care of older people and care of children with cerebral palsy, and to help members in private practice tackle the policy issues in their control.
Care of Older People In 1986 WCFT working with the World Health Organisation (WHO) funded research into elder care and in 1987 issued the first report (WCPT/WHO, 1989). This report provided guidelines for national associations planning care services for older people. One of its major recommendations was that training specific to elder care should be implemented in each country. The next step was for the Confederation to combined forces with the International Institute on Ageing (UNMalta) to plan how training might be planned. The work of an expert group, meeting in 1992, resulted in a second report specificalIy on curriculum building (WCF'T/INIA, 1992). The intention was that this curriculum should be tested among an international group who would not only evaluate its impact but would be able to implement similar or ancillary activities in their own countries. The test group of 33 students from 22 countries attended the first course in Malta in October 1993 and since then a number of initiatives have been put in place by the students in their own countries including surveys, reports, newsletters, contact groups and specialist seminars. At three regional meetings - NACR, AWP and Africa - students gave specialist seminars and at a seminar on elderly care organised by the Standing Liaison Committee of Physiotherapists in Europe, some
MISSM O'Hare and Pmfessor A J Fernando, secretary-general and president of the World Confederation for Physical Therapy
Physiotherapy, September 1994, vol80, no 9
students had the opportunity to present the Malta curriculum. The concept underlining all the activity described above is important - namely that the initiative at international level is intended to be seminal and that the important outcome is the subsidiary cascade initiatives a t national and regional level. The Confederation has been asked to organise a second international course, but the executive wants to be sure that this is a priority rather than another specialty care area.
Care of Children with Cerebral Palsy The intention and method were somewhat different with this initiative. During a visit by the executive to Africa in 1988, members indicated that one of the most intractable problems was the treatment of children with cerebral palsy in very rural settings where the visit of a physiotherapist is a luxury and a trip to the physiotherapy department of a hospital often impossible. Physiotherapists having to cope with the situation were few in number, and could not absent themselves for specialist training, but wanted help. The method of help devised was to get together a team. of tutors who devised a short course which they took from country to country in Africa as a 'travelling workshop'. This was so successful and appreciated, that W H O approached the Confederation with the idea of producing a manual for carers, whether professional mid-level workers or families, based on the workshop content. At first this idea was resisted a little, considering that a large number of very good published texts already gave guidance. However, finally convinced that a specific text was necessary, the Confederation again joined forces with WHO but this time also with the World Federation of Occupational Therapists to produce a text (WCPT/WFOT/WHO, 1993) which has been a runaway success and is currently being translated into other languages.
Private Practice Again a somewhat different approach was used to foster international debate on the issues faced by the fast growing community of private physiotherapy practitioners worldwide. In this instance the Confederation organised a n international four-day meeting of presentations, debates and round tables where various viewpoints on policy issues throughout the world could be compared. The intention was to consolidate private practice policy as much as possible at international level in order to help members in whose countries the ethos of private practice is not yet founded; and to help members working in countries with a well established private practice community but where legislation, insurance and other issues are not always favourable to physiotherapy. Those who attended this event have asked the Confederation to organise a second meeting and this may in fact result, but as with the idea of a second course on elder care, the Confederation wants to establish whether it might not be preferable to tackle other areas of physiotherapy concern worldwide.
617
The Confederation’s Gratitude to Executive Committee Members, Consultants, Tutors Someone has to plan, implement, evaluate and pay for the activities, and physiotherapists in all member countries are involved. To start with finance - although all costs are kept low thy funding for these projects comes from Confederation funds, managed by the Executive Committee. Member organisations contribute from the subscriptions paid to them by individuals in each country. But the vast debt of gratitude goes to all the ‘volunteers’ involved: .The Executive Committee members who are all assigned specific tasks (eg the position statements and declarations of principle were devised by a volunteer task force chaired by a committee member, as was the regionalisation evaluation task). .The consultants and tutors who gave their time to organise research, and conduct workshops or seminars, and who receive expenses only. This represents a huge commitment and contribution to the Confederation which could not be obtained any other way.
So What comes Next? Future activities which the Executive have in mind involve: .Further joint work with W H O and WFOT (the Confederation is committed to the concept that partnerships provide a better outcome). .An expanded publication programme - in addition to the Newsletter, plans are on the drawing board for a physiotherapy international terminology/dictionary and an international journal on professional (rather than clinical) issues. .Further international meetings, short courses and specific conferences, study visits, etc.
So please watch for news of these developments.
Confederation Data 54 members (national associations) 11 members elect (full membership to be ratified at the 13th General Meeting in Washington) 5 Regions Representing well over 200,000 physical therapists Executive Committee President - Prof A J Fernando Vice-president - M r David Teager Regional Members
Africa - Mr Geoffrey Moyo Asia, Western Pacific - M s Doreen Bauer Europe - Ms Pirkko Kuurne North America, Caribbean - M s Sally Edelsberg South America - M r Pedro Mancilla Secretariat Secretary General - Margaret O’Hare Executive Secretary - Cordelia Ohanian 4a Abbots Place, London NW6 4NP (tel 071-328 5448, fax 071-624 7579) Registered Charity No 234307.
References Chartered Society of Physiotherapy (1994). ‘Hands across the sea (and land)’, Physiotherapy, 80, A, 60A - 62A. Sutcliffe, B (ed)(1989).The Role of Physical Therapy in the Care of Elderly People, WCPTIWHO. Available from WCPT secretariat, f 20.
WhCPT/lnternational Institute on Ageing (UN-Malta)(1992).An Ageing World: Pysical implications and training strategies. Available from INIA, 117 St Paul’s Street, Valetta ULT 07, Malta,
Author
free. WCPTIWFOTNHO (1993).Promoting the Development of Young
Margaret O’Hare MSc has been secretarygeneral of WCPT since July 1986. She will retire on June 30, 1995, immediately after the Washington Congress.
Children with Cerebral Palsy: A guide for mid-level rehabilitation workers. Available from the Rehabilitation Unit, World Health Organisation, CH-1211, Geneva 27, Switzerland,one copy free.
~
Physiotherapy, September 1994, vol80, no 9