Students from the new physical therapy programme in Malawi pictured with Sylvia Kambalametore (standing extreme right).
Students from the new physical therapy programme in Malawi pictured with Sylvia Kambalametore (standing extreme right).

A landmark for physical therapy education in Malawi

The first ever qualifying education programme for physical therapists began in Malawi last month after 17 years of campaigning and planning. The driving force behind the programme, Sylvia Kambalametore, talks to Simon Crompton about what it took to finally educate Malawian physical therapists on their own soil.

There are 14 million people in Malawi, and just 27 physical therapists. Only 15 of those physical therapists actually come from their homeland, and none of them are currently educated there. How can you begin to address that shortfall, and meet the rehabilitation needs of the population?
 
For Sylvia Kambalametore, the answer has long been clear: establish a national physical therapy education programme. But it has been a hard battle to convince policy makers that something had to be done, and then to gain the backing to finally put plans into place. 
 
“Because physical therapists are so thin on the ground in Malawi, and because they are based only in the main referral hospitals, the first problem has been to educate people about what the profession does,” says Kambalametore, who is Chair of the Physiotherapy Association of Malawi, and the WCPT Executive Committee member for Africa. Policy makers in particular were unaware of the contribution physical therapists could make, and Kambalametore made a point of addressing as many meetings and boards as possible to try and communicate their importance.
 
There were concerns from some policy makers that physical therapists were an expensive luxury in such a poor country. But these were countered with the argument that they considerably reduced the economic impact of disability, says Kambalametore.
 
There were also local calls for the introduction of “middle level” rehabilitation workers, rather than fully (and expensively) trained physical therapists, but Kambalametore knew this was not the answer. “It was clear that we had to train people to a higher level – they needed skills not only to treat but to educate the public, and to head departments – because skills are so thin on the ground. We needed people who could lead, and had problem-solving skills. We needed something sustainable.”
 
So physical therapists began advocating for a degree course, and in 1995 proposed to Malawi’s only Medical School that it consider setting up an associated school of physiotherapy. By 2000, the Medical School decided to make a physiotherapy programme part of its expansion plan. 
 
“So we began advocating again,” says Kambalametore, who was at one point the only physical therapist in Malawi. The University of Tromso in Norway provided expert advice on course development, and together with representatives from the physical therapy associations in Tanzania, Zimbabwe, Zambia, South Africa and Malawi also provided input on the curriculum.
 
“The challenge was to come up with a curriculum that conformed to the international standards defined by WCPT but also addressed the needs of Malawi. It is extremely important for us to have a community-focused approach to our work, and this needed to be reflected in the programme content. Around 80% of people in Malawi live in rural areas.”
 
Among those who gave advice and support were Dorcas Madzivire from Zimbabwe, a former WCPT Vice President, and Dele Amosun from the University of Cape Town, South Africa, who was a driving force behind the physical therapy degree programmes in Africa. Sylvia Kambalametore carried out several fact-finding trips in Africa and Europe. From the USA, the University of the Pacific helped with faculty development for the school.
 
Then, in June 2009, the President of Malawi told Parliament that the new programme would start.  Based at the University of Malawi College of Medicine, it is a four-year BSc Honours degree in physical therapy.  Because the majority of young people in Malawi do not study to university entry level, most of those wishing to join the degree course need to complete a foundation course beforehand. After they have completed the degree, they are expected to complete a one-year internship, to ensure they have the skills and competencies to manage staff and run community programmes.
 
Last year 26 people took the foundation course, and 25 of them started the physical therapy programme in December. “The implications of that are huge for Malawi,” says Sylvia Kambalametore. “Four years down the line, we should almost double the number of physical therapists in the country. After so many years of waiting, it’s history in the making.”
 

Appeal

Sylvia Kambalametore svktore@africa-online.net would like to hear from you if:
  • you are a retired physical therapist who would qualify to teach at a university and would like to be part of the experience in Malawi;
  • you would like to contribute to the programme in other ways, such as sponsoring a student, or donating teaching materials, learning materials or computers.