CAHI FELLOW - PANAMA
REHABILITATION SERVICES FOR PEOPLE WITH DISABILITIES IN INDIGENOUS REGIONS OF PANAMA
Dr. Ingrid Gonzales is a physician specializing in physical medicine and rehabilitation. During her time as a CAHI Fellow, she served as Director of the National Office of Integrated Health for the Population with Disabilities within the Ministry of Health of Panama.
ABOUT THE PROJECT
Dr. González is incredibly dedicated to her work. She is on the board of four national physical rehabilitation facilities: the National Institute of Physical Medicine and Rehabilitation, the Ann Sullivan Center of Panama (serving children with autism and Down Syndrome), the Panamanian Institute for Special Habilitation (IPHE), and the National Disability Program (SENADIS).
Her goal is for disability to be widely-recognized as a transversal theme in all the healthcare services provided by the Ministry of Health. The project she developed in the CAHI Fellows Program was the design and implementation of rehabilitation strategies for people with disabilities in the indigenous regions of Panama.
Dr. González clearly understands the needs of the country, where more than 400,000 people, or 11.3% of the population, live with some type of disability. The 16 rehabilitation facilities operated by the Ministry of Health are insufficient to meet the patients’ needs in densely populated areas, and even more deficient in indigenous regions that are difficult to access. In Bocas del Toro, for example, 30,000 people do not have access to these services because of the distances and challenging conditions presented by traveling to the nearest facility.
Community-based rehabilitation offers an alternative solution. International protocols established by the World Health Organization (WHO) and the Pan American Health Organization (PAHO) require the implementation of educational strategies for health promoters, community leaders, parents or guardians; to raise awareness of the rights of people with disabilities and provide training to them for the community-based rehabilitation and, subsequently, the full integration of people with disabilities into their communities.
Dr. González notes, “In Panama the rehabilitation staff is scarce, there are only 47 rehabilitation doctors in the whole country to serve 4 million people. In Panama there are occupational therapists and physiotherapists, but we do not have enough space to hire these professionals in the rehabilitation facilities that exist throughout the country. This is why it is important to not only create changes in public policy, but it is also urgent to change the paradigm from which we are serving people with disabilities. For me, the key is in community-based rehabilitation. We need to understand that the person with disabilities can also be productive and integrate into their community.”
Dr. González has already started the implementation of her project with her team in the indigenous community of Kankintú, a town in the Comarca Ngöbe Buglé with about 400 homes, in which she has identified 90 people with disabilities.
The team led by Dr. González included an occupational therapist, speech therapist, prosthetic orthotist, physical therapist and a social worker.
The team have evaluated and diagnosed those with disabilities and provided them with a free informational care card. In addition, the team has spoken with community leaders to explain the project and coordinate the next steps of implementation. Currently, guides and manuals are being generated for the community-based training that are adapted to the specific needs of the identified disabilities. These guides and manuals will be shared with the community during training sessions.
PROGRAMA CAHI FELLOWS
The CAHI Fellows Program provides tools and technical knowledge for the development, implementation, and monitoring of a project in an organized manner, with a clear focus on the objectives and goals to be achieved.
Additionally, and perhaps one of the greatest values of this program, are the relationships and friendships that are cultivated among CAHI Fellows, who currently constitute a network of more than 100 members throughout Central America. They are united by their commitment to improve medical care and access to health services in their countries.
For Dr. Gonzáles there have been many opportunities to exchange valuable information and support. For example, she mentioned her colleagues in Guatemala, who have established a collaborative relationship to share experiences in early diagnosis of some types of disabilities, through a research instrument developed in Mexico. She describes her relationships with Costa Rican CAHI Fellows as very productive due to their advanced approaches to public health, which offers learning opportunities for Panama.
She says, “The CAHI program, in addition to academic teaching, also strengthens our values. The CAHI network can have a great impact on the region and things can improve, because we have learned to process information better, consider the indicators and the real needs, which is just as important as combining that technical knowledge with a high sense of ethical values. I think that we can do something very good to improve health together.”
Panama is a signatory to the Convention on the Rights of Persons with Disabilities and there is a global rehabilitation and care plan in place. In Panamá, through the Ministry of Health (MINSA) there is a strategic plan that follows the guidelines of these global agreements, which is being implemented, while recognizing significant challenges, to continue improving and making progress. This project represents an important step for the country and highlights the real commitment to achieve the full integration of people with disabilities in society.