Development Challenges for Orthopedic Centers in Africa (Case of Mali)

Over the past thirty years in the field of functional rehabilitation, and particularly orthopedic prosthetics, I have observed that many centers in Africa are struggling to develop. This editorial is an opportunity offered by FATO to modestly share an analysis of the situation of our profession.

At the Level of National Health Policies.

Even though a significant number of African states have ratified the International Convention on the Rights of Persons with Disabilities, its implementation remains ineffective. This observation was made during conferences organized by FATO in Tanzania and Côte d’Ivoire. Furthermore, the dual supervision of centers, between ministries (Health and Social Development/Social Affairs) in the same country, impacts the development of functional rehabilitation.

At the Level of Human Resources. The current situation is a lack of human resources in almost all centers, despite the existence of training schools in Togo, Tanzania, and elsewhere in the Maghreb. The increasing prevalence of people with disabilities is due to wars, diabetes, and traumatic accidents. Aging staff members who stop working for various reasons and are often not replaced. Added to this is a lack of skills due to the lack of Level 1 certification in several countries and a lack of continuing education.
Regarding the supply of imported raw materials.
Today, despite the opportunity to source imported raw materials offered by the African Organization for the Development of Centers for People with Disabilities (OADCPH) based in Lomé and the PROTEOR representation in Ouagadougou, the centers are still unable to obtain supplies. This situation is due to a lack of organization and inadequate management.
Regarding the work environment. Many centers are housed in small spaces that often do not meet international standards. Provincial centers, in particular, are most often located near the morgue or infectious disease unit, or in renovated, subscribed buildings. This often explains the lack of awareness of the services provided by technicians by the managers who run the unit.
Staff motivation
Rehabilitation staff do not receive the same incentives as other workers in the same unit.
Who ever heard of an orthopedic technician receiving a national medal of merit?
The quality of care.
The dilapidated condition, inadequacy, and lack of small machines, tools, and equipment contribute to the lack of quality care.
Few centers have been able to repair old machines due to a lack of spare parts or purchase new ones.
Until all these elements are met, the development of orthopedic prosthetics centers in Africa would be difficult. This is why I agree with GOGUE’s (J., P., 1997, Quality Management WWW.2.unil.ch) idea, which states that, in order to listen to the customer’s voice, one must master the “M” factors that affect quality. These factors include, among others: Materials, Labor, Equipment (Machines), Workplace, Work Methods, Management (Corporate Culture), and Financial Resources.
Thank you for reading this.