Nigeria Physiotherapy Network

This Feature Article is an Address of a doyen of Physiotherapy in Nigeria Dr. T. Abayomi Oshin to the 39th Annual General Meeting of the Nigeria Society of Physiotherapy. We now present a minimally edited version. 

PHYSIOTHERAPY IN NIGERIA: YESTERYEARS, PRESENTLY AND IN THE NEXT MILLENIUM 
BY 
DR. T. ABAYOMI OSHIN, J.P. PH.D, M. PHIL. B.P.T., M.C.S.P., DIP T.P, M.C.P.A., M.N.S.P., 
DURING THE 40TH ANNIVERSARY CELEBRATION OF THE NIGERIA SOCIETY OF PHYSIOTHERAPY
OSUN PRESIDENTIAL HOTEL, OSOGBO, OSUN STATE, NIGERIA
FRIDAY 10TH DECEMBER 1999.

The President, Nigeria Society of Physiotherapy, Executive Members, Nigeria Society of Physiotherapy. It gives me a great pleasure to be amongst you today and I thank you for inviting me to give anniversary talk on this special occasion- the 40th birthday of the Nigeria Society of Physiotherapy. I pray that we should have the opportunity to witness many more anniversaries of our great Society. 

WHAT IS PHYSIOTHERAPY?
"Physiotherapy (physical therapy) is the art and science of physical treatment by means of therapeutic exercises, instructions, heat, cold, light, water, message and electricity. Some of the aims of the treatment are the relieve of pains, the increase of circulation, the prevention and correction of deformity, maximum return of strength, mobility and co-ordination". 

Physiotherapy also includes the carrying out of electrical and manual tests to determine the amount of impairment of nerve supply and tests to determine the amount of impairment of nerve supply and the strength of muscles, tests to determine functional abilities; measurement of range of joint movement, and measurement of vital capacity as diagnostic aids and for recording progress. 

Physiotherapists work to prevent disability and to rehabilitate the sick and the handicapped. They are also active in preventive medicine and in clinical research. To give the history of the modalities used by physiotherapists will take a whole day. 

HISTORY OF PHYSIOTHERAPY IN NIGERIA
Physiotherapy was introduced into Nigeria in 1945 by two British Chartered Physiotherapists: miss Manfield and Mr. Williams. They were employed by the government of Nigeria and attached to the Orthopaedic Hospital, Igbobi, Lagos. Their primary assignments were: 
• First, to treat wounded and disabled Nigerians soldiers who returned home from Burma and other countries during the Second World War. 
• Secondly, they were to start a training programme in physiotherapy. The three-year diploma course was attended by a number on Nigerians. 

On completion of the training and passing out of the school, they were designated as Assistant Physiotherapist. They were specifically asked to work strictly under the supervision of Chartered Physiotherapists who had trained in England. 

With time, the training programme at Igbobi was discontinued. Just before then, plans were in progress to start a diploma course at University College Hospital, Ibadan. This was later changed to the Bachelor of Science Degree in Physiotherapy at the University of Ibadan. The course took off in October 1966. The graduation of the foundation students in Ibadan in 1969 was a landmark in the annals of physiotherapy in Nigeria. Thus, University of Ibadan was the first in Nigeria and West Africa, to award a degree in physiotherapy. 

In 1971, University of Lagos commenced a three-year diploma course, which was upgraded to Bachelor of Science Degree in 1977. University of Ife, Ile-Ife (now Obafemi Awolowo University) followed Ibadan and Lagos in 1977. The course at Ile-Ife was for a four year Bachelor of Medical Rehabilitation. The University of Nigeria, Nsukka also commenced   a degree programme in 1987. There is also a training programme in Kano. It is to be affiliated with the Bayero University, Kano in future. 

The products of the Universities are practising as Physiotherapist in many establishments in the country and abroad. Some are lecturers in Universities in Nigeria and overseas. A sizeable number are in United Kingdom, United States of America and Canada pursuing postgraduate courses and working to gain further experience and for pecuniary purpose. Several Nigerian Physiotherapists are known to be in employment in Saudi-Arabia. The vogue at home has gradually shifted from working in teaching, state and specialised hospitals to venturing into private practised by a handful of practitioners. We should be mindful of mediocrity. 

NIGERIA SOCIETY OF PHYSIOTHERAPY
The Nigeria Society of Physiotherapy was founded by two Physiotherapists. They were. Messrs. T. Abayomi Oshin and C. Agboola Ajao in 1959.  The Inaugural Meeting of the Society took place at the University College Hospital, Ibadan on 29th August 1959. Practising Physiotherapists were invited by the founders to attend the meeting. 

The foundation members of the Society were:
Miss H. M. Joyce,
Mrs. S.A. Ajao (nee S.A. Ajala)
Mrs. M.T. Payne (nee M.T. Walton)
Mr. T.A. Oshin
Mrs. L.E. Day (Mrs. L. E. Baker)
Miss H.M. Munro.
Mr. I.O Ayodeji
Mr. C.A. Ajao. 

Officers elected at the Inaugural Meeting were:
Chairman:           Mrs. L.E Baker
Vice Chairman:      Mr. I. O. Ayodeji
Honourably Sec.:    Mr. C. A. Ajao
Treasurer:          Mr. T.A. Oshin 

Within a short period  (1961-1962) the society was recognised by the Federal Government and other Regional Governments. It was the only body that had the power to negotiate with the governments. 

State chapters of the society emerged after a few years. They were all under the umbrella of the parent body, Nigeria Society of Physiotherapy (NSP). 

For seventeen years, meetings of the NSP were held at Ibadan and Lagos respectively. As membership increased in various sector of the country, meeting venues shifted from the established bases to Enugu in 1976, Zaria in 1977, Ife in 1978, Lagos in 1979, Benin in 1980, Owerri in 1981, Kano in 1982, Jos in 1983, Akure in 1984, Lagos in 1985, Ilorin in 1986, Port-Harcourt in 1987, Enugu in 1988, Abeokuta in 1989, Kaduna  in 1990, Ibadan in 1991, Kano in 1992, Markudi in 1993, Calabar in 1994, Kano in 1995, Lagos in 1996, Lagos in 1997, Zaria in 1998, Osogbo in  1999. 

WORLD CONFEDERATION FOR PHYSICAL THERAPY (WCPT) AND NIGERIA SOCIETY OF PHYSIOTHERAPY (NSP)
The existence of the NSP was made known in 1960 to the World Confederation for Physical Therapy with the view of becoming a member of the World Body.

On application, the, the N.S.P was granted provisional   membership in 1996. It was invited in 1967 to the 5th International Congress of the WCPT which took place in Melbourne, Australia. Three NSP members: Messrs Ajao, Kehinde as well as Mrs. Aboderin were present at the memorable congress where Nigeria Society of Physiotherapy was formally admitted as full member of the World Confederation for Physical Therapy on the afternoon of Thursday 18th May, 1967. Since then, members of the of the Nigeria Society of Physiotherapy had attended the International Congress held by the World Body. Some even occupied positions in the Executive Committee. Scientific papers were presented by our members as far back as 1970 in Amsterdam; 1974 in Montreal, Canada; 1978 in Tel Aviv, Israel; 1982 in Stockholm, Sweden, 1987 in Sydney, Australia, 1991 in London, United Kingdom; 1995 in Washington D.C., United States of America; 1999 at Yokohama, Japan. 

We have had the privilege to welcome past President of WCPT, Mr. Eugene Micheals in our  midst in 1975. He then launched the NSP's booklet on "Guidelines on the Training of Physiotherapist in Nigeria".  The same was true with past Secretaries of WCPT in the persons of Miss M.J. Nelson M.B.E, 1968 and Miss E. M McKay 1979 

We were also opportune to have Miss M. Hollis, M.B.E., run a course on P.N. F at the College of Medicine, Lagos University in June 1977. Miss Hollis was the Principal of the School Physiotherapy, Bradford, England. 

PAN AFRICAN CONGRESS/AFRICA PHYSIOTHERAPY ORGANISATION 
The First Pan-African Physiotherapy Congress was held in the Old Great Hall, College of Medicine, and LUTH by the Nigeria Society of Physiotherapy on May 28th to June 3rd, 1979. The Congress was a processor to the African Physiotherapy Organisation. The Executive Committee of the Organisation met in Cairo, Egypt in and Mr. Odia as the Newsletter Editor. 

THE COVETED DECREE 38
The long awaited recognition of the Nigeria society of Physiotherapy as an independent registration body was achieved in 1989 when decree No. 38 on Medical Rehabilitation Therapy was promulgated. 

In the same year, the Federal Government appointed physiotherapists to represent the N.S.P on the following bodies:
a. National Advisory Health Committee.
b. National Policy on Medical Rehabilitation.
c. Board of Management of Teaching and Specialist Hospitals.
d. Medical Rehabilitation Therapists Board of Nigeria. 

JOURNALS & SOME BOOKLETS OF N.S.P.
The Nigeria Society of Physiotherapy published its first journal, the Maiden Issue in 1969. Other historical publications are:
• "First Decade" By Mr. C.A. Ajao in the Maiden issue of the N.S.P. Journal. 
• Also by the same author  (Mr. Ajao), "The Nigeria Society of Physiotherapy in African in 1982. 
• Mrs. S. Ajao published  " Handbook of Nigeria Society of Physiotherapy" In 1974 and reprinted same in 1976. 
• "Nigeria Society of Physiotherapy at 25" was published by the society during the Silver Jubilee Celebration in June 1985. 
• ‘Guidelines on the Training of Physiotherapists in Nigeria" by the N.S.P. in 1975. 
• ‘Code of Ethnics" released in 1978 by the Society.

STUDENTS ASSOCIATIONS
Student bodies have played no mean role in the propagation on of efficient health care delivery through workshops, seminars, sports, conferences, magazines, journals and others. The first students' association was formed in Ibadan in 1978. It was then called "Association of Undergraduate Physiotherapists".  The name has since changed to "Association of Physiotherapy Students". (APS). Lagos also has University of Lagos Association of Physiotherapy Students (ULAPS). Ile-Ife and Nsukka also have student associations. 

The parent body of all the local associations is the Nigerian Association of Physiotherapy Students (NAPS). The body holds Annual Scientific Conference since its inception in 1981. Its conference is mother of all local conference in individual university. All the associations publish scientific journals. The first journals  (Vol. I and II) were published by the Association of Undergraduate Physiotherapists of the University of Ibadan in 1978. It was called Physiomag. That of NAPS is called Physiotherapy BUD and was first published in 1989. 

THE PRESENT
We accept the fact physiotherapy is a profession. "We, as physiotherapists, treat patients referred to us from many disciplines of medical profession viz medicine, surgery, paediatrics, neurology, obstetrics and Gynaecology, Dentistry, Psychiatry, Otorhinolaryngology (ENT.) and others. We do not only treat these patients, we also follow their progress until they achieve full recovery where possible. In some cases, it is in consultation with other members of the health team.  But the methods and equipment used by a physiotherapist are determined by him. He decides, independently, alternate forms of treatment to effect the best results".

‘Physiotherapists are not sub-servient to one profession. They are not auxiliary -personnel which means in the "secondary" or "accessory, position. Physiotherapists, nurses, occupational therapists, physicians, medical social workers, Orthotists, prosthetists, physicians, medical social workers, othostists, prothetists   and all other health professions, join together as a team to provide the patient with the kind of care each profession can best offer". 

However, are our young graduates getting what they should have and hold under the present economic predicament? Many physiotherapy schools and departments cannot replace broken down equipment for the training of students. The same apply for those in clinical areas. Do we maintain these standards today? 

Textbooks are not within the reach of students. They cannot plough through books in the Library to enrich or even acquire knowledge.  The solutions lie in the reduction of tariffs on textbooks by the government. In the alternative, senior members of the profession, who are up-to-date with modern trends, should produce monographs on specific subjects.  Textbooks will cost much more than monographs. 

COMMUNITY PHYSIOTHERAPY
Students should be exposed to rural and Community Physiotherapy practice during their training.  Majority of the Nigeria citizenry live in the Sub-urban areas.  Students should learn how to design, improvise and use supportive and therapeutic gadgets as form of appropriate technology. 

When in the 1960s, the problem arose in Ibadan where taxicabs refused to carry users of axillary crutches to the hospital because of lack of space for them in "Morris Minors" and even in the other small cars, the speaker designed "Folding wooden Crutches".  They solved the problem and the taxicabs accommodated them. 

THE FUTURE
We should aim at specialisation so that we are not labelled as "Jack of all Trades and Master of Non".  Therefore physiotherapeutic specialisation in the following areas should be further encouraged and pursued.  The areas are: Biomechanics, Kinesiology, Electro-physics, Electro-therapy, Exercise-therapy, Neurology, Sports Medicine, Paediatrics, Manipulation, Geriatrics, Community, Industrial, Cardio-thoracic, Medical and Surgical conditions, Orthopaedics and others. 

We should engage in research activities on subjects and conditions relevant to our profession and environment.  We ought to prove the effectiveness of our modalities, in patient care scientifically, through research methodology.  It is of utmost importance that scientific and professional journals should be made available in the teaching and clinical areas. We need to up-date our skill and knowledge by reading current journals. 

Aside from patient care, the welfare, remuneration, salaries and status of the practitioners should be reviewed from time to time by employing agents. 

ON A HAPPY NOTE:
I am sure you know that a sizeable number of the graduates from our Universities are heads of Departments and Lecturers of Physiotherapy in Nigeria today.  Also that graduate physiotherapists from Nigeria are heads of divisions and departments in the United Kingdom, United States of America and Saudi Arabia? Many others had proven, in other ways, the high standard of training they received in Nigeria during their time.  I however, pray fervently that our professional colleagues who are over overseas should come home and contribute their expertise and experiences to the development of physiotherapy education and clinical practice in Nigeria. 

CONCLUSION:
I will end by passing on to you what I had repeatedly said on occasions such as this. 

1. We are expected to base treatments on new knowledge and less on tradition, routine, and ineffective care.
2. We should be alert to modern trends, techniques and resources material. Therefore, read current physiotherapy and other relevant journals.
3. We should carry out duties with dedication, devotion and full sense of responsibility to our patients and the public at large.
4. We should give our patient his money's worth for every visit to our clinic or department.
5. We should be critical of what we do, of the modalities and procedure we use.
6. We should consult, always, our senior colleagues and others who are more knowledgeable and competent when in doubt. Remember that we can only treat that which is within our competence.

When we have accomplished all of the above and demonstrated intellectual skills and therapeutic accomplishments, we will have self satisfaction and other members of the health team".

Thank you.  
Dr. T Abayomi Oshin