Field Manual of Rehabilitation
This manual is not a textbook of traumatology; rather it is specifically directed towards the rehabilitation of survivors of TOV, from 3 months after the trauma and onwards. It is an attempt to provide practical recommendations for health workers at different skill levels.
Since many years, RCT representatives in the field have received
numerous questions about specific health advice regarding torture
survivors and their rehabilitation. The new RCT Field Manual on
Rehabilitation is intended to meet that need for evidence-based or
consensus-based advice in attempts to rehabilitate survivors of TOV
in regions lacking specialized medical care.
Rehabilitation approach
The organization and emphasis of the manual is one of its
kind. It is problem-oriented, not professionally oriented, since
the survivor presents with one or several problems and does not
usually have access to multi-professional healthcare. It uses the
globally developed concepts of the International Classification of
Functioning & Disability (ICF; WHO, 2001) rather than diagnoses
from Western medicine. This serves to emphasize the rehabilitation
approach, which is focused on a person's ability to be active and
to participate, rather than on disease or on remaining injury. Thus
the problems are listed in the three sections: Body Functions;
Activities & Participation and Context.
Interdisciplinary and integrated approach
Each entry word defines a problem that a survivor may
experience and the advice given is presented at three levels: 1)
for a healthcare assistant or layman with some training); 2) for a
healthcare professional; and 3) for a physician with the relevant
specialization. A separate section details commonly employed
therapies in TOV survivor rehabilitation, followed by selected
references. The compilation has an interdisciplinary and integrated
approach and contains physical, physiological, pharmacological,
psychological, social, psychiatric and therapeutic aspects.
Emphasizing cultural perspectives
At RCT, we are very much aware that the general knowledge
and cultural traditions in a local community are extremely
important for the satisfactory outcome of rehabilitation efforts.
Therefore, the manual is by no means an attempt to impose a Western
model of health care without acknowledging local customs and
practices. Only by acknowledging and integrating local concepts of
health, disease and healing can rehabilitation, group cohesiveness
and empowerment be successfully promoted. RCT therefore recommends
that the advice given should be combined with such contextual
inputs.
Evidence base and experience
Hopefully, the manual will constitute a valuable tool and
guide in therapy, not only for survivors of TOV, but also those of
other psychosocial traumas. The authors have been assembled from
present and past staff from the RCT rehabilitation, research and
international departments, using up-to-date systematic reviews of
controlled clinical trials as well as their extensive experience in
rehabilitation for the advice given. The text is also the result of
active and open exchange via workshops and the RCT's joint work
with partners. It is through this open and integrated approach
between science, practice and contextual experience that RCT may
contribute significantly as a knowledge center.
Content
list