WCPTの国際協力における問題と今後の方向性

Japanese Physical Therapy Association

NII-Electronic Library Service JapanesePhysicalTherapy Association

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ngSImsra

I

International

Its

Cooperation

of

WCPT

Future

Direction"

and

Margaret

Introduction

I

have

been

asked tospeak to you about

interna-tional

cooperation in physical

therapy

and would

liketotellyou a littleof what has been achieved so

far,

what

the

benefits

of

being

`international'

are, what the

benefits

of

being

Regionalised

are, what remains

to

be

achieved.

Histery

International cooperation in

Physical

Therapy really began in 1951 when 11 national _physical

therapy

associations initiated

the

World

Confedera-tion,

The objectives were toexchange information,

improve

education and _practice,encourage research

and cooperation with other

international

health

care organisations. Over 40 years the objectives

have not substantively changed, but the size and structure of the Confederation has changed. The

Confederation

now consists of

54

national

associa-tions

(and

4 members elect) represents 18,OOO

Phys-ical

Therapists

worldwide, and most

importantly

since

1991

(oMcially)

now consists of

5

Regions

WCPT

Africa

WCPT

North

America-Caribbean

WCPT

South

America

WCPT

Asia-West

WCPT

Europe

The reason

for

Regionalisation

was tomake

co-operation more viable-on the basis that member

' _{wcpT aMenuz7] vLtset6}

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('ULtpmva#tutttmeeaijigee

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O'Hare'*

'

organisations in a _geographical region should

find

iteasier to meet together and to _plan

joint

ac-tivities-the

factors

being

that

distances

should

be

shorter, travelshould

be

cheaper and that _physical

therapy

`cultures'

might be more similar. Problems of

language

might also be helped-for instance in

Europe they work in English and French, in

South

America

in

Spanish,

although the other

3

regions stilluse

English

as

the

working

language.

What

has

been

achieved?

In

40

yearsa

_great

deal

has

been

achieved

-cooperation

on education _programs, advice and

training from one member

to

another

has

raised _the

level

of physical therapy training

worldwide

-in

exchange and visitstoother countries

cal

Therapists

have

worked

in

other cultures

and envirorrments and

learnt

other methods

-the

developrnent of internationalethical

pleshas produced a standard for

the

_profession

as a whole

･--recently

there

has

been

extensive cooperation

with the World Health Organisation

in

two

areas ofinterest

i)physical therapy care of elderly _people

ii)physical therapy care of children with

bralpalsy

The outcome of theseinitiativeshas ledto

-a

pilottrainingcourse for Physical Therapists

inthe care of elderly _people inOctober of this

year

jointly

with theInternationalInstituteon

Aging

(United

Nations-Malta)

Japanese Physical Therapy Association

NII-Electronic Library Service JapanesePhysicalTherapy Association

International

Cooperation

of

WCPT

-A

manual on thecare of children with cerebral

palsy has been produced

jointly

with

World

Health Organisation and the

World

Federation

of Occupational Therapists

-Within

and between Regions member

tionsare cooperating on a one-to-one basisor

"twinning".

For example members inEurope have twinned

with associations inEastern Europe and

Africa

and

WCPT

Europe

issues

a

Newsletter

changing

information

among merpbers.

In

North

America-Caribbean

they are setting

up _projectsto help traininginCaribbean

tries,

In Africa

there

iscooperation on a _physical

therapy curriculum for Africa,and on

tation

issues

they

have

already

issued

an

can

declaration.

Here

in

the

Asia-Western

Pacific

Region,

spite being thernost vast, thereare plans te

operate on CBR projects, togather

information

on _physical therapy education and _practiceand

to fund _projects within the Region using the

Australian

Physiotherapy Association ment Fund which isopen toall members of the

Asia-West PacificRegion.

Why

an

International

Body

is

necessary

Apart

from

encouraging exchange of

informa-tion,techniques and training as described, the

remit of an international body

is

to support

its

member organisations in theirnational

initiatives.

Promoting change

in

a national

health

_policy

is

very

dithcult

for

small communities such as

physi-cal therapists. But subrnissions tonational

Govern-ments are greatly enhanced by the backing of an

internationalbody, ifonly topoint out what is

hap-pening elsewhere inthe world. Two specific cases are

-the

autonomy of

Physical

Therapists

-the

_development of PrivatePractice.

Inseme countries the_profession

is

still controlled

by Physical

Medicine

doctors or similar,

but

the

and ItsFuture

Direction

419

Confederation

as an

international

body,

has

been

able to point out that thisisnot standard practice

elsewhere

in

the world and the _practice is now

lessening,

Also

questions of `direct access' and private

prac-ticehave been

helped

inmany cases by the

interna-tionalbody

being

able to quote _practicesand

legis-lativesinother countries, thus helping negotiations with Governments.

Also

the Confederation'srecent

Private

Practitioners'

International

Meeting

has

helped toconsolidate _{generalpolicy}on

Private

Prac-ticeand to show the

importance

of this

develop-ment. The

Report

should be invaluable to our

members still pursuing

legalisation

of directaccess and _private

practice

intheircountries.

Recent}y also the Confederation has issued its first

two

International

declarations

on

-cornmitment

to the United Nations Rights of

the

Child

-international

_guideline$ on the treatment of torturevictims.

These

declarations,

endorsed at

international

level,are available and intended forgtiidance of

na-tional_physical therapy associations to help devise

theirnational

programmes

and/or todeclareto

na-tional_governments.

What

has

still

to

be

achieved at

International

level?

-Standards

As a _{profession grows} and needs

to

be

seen as

`uniform'

worldwide, the requirement forstandards and

definitions

are

brought

to

bear.

This

is

exactly what

happened

at the

Confederation's

1991

General

Meeting,

where members asked theExecutive Com-mittee to

look

into

various issues

-standards

of physical therapy education and

practice

-definition

of _physicaltherapy

-four

year university

degree

course.

At

present a Task

Force

on

Standards

isworking

hard

on this

diMcult

problem and you are lucky to

have the

Chairman,

Doreen

Bauer,

here

should you wish tota!k to

her

about thistask. There are

ele-Japanese Physical Therapy Association

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veYtaza7

mentary considerations of

-who

sets thestandards

-who

monitors them

-what

_happens

_if

_in

_{some countries}

_these

ards are net achievable.

Iam sure you can allsee the _{problerns-but}

it

is

something thatan

international

body

should tackle even ifitistosay at the end of the day that the

problems outweigh

the

benefits,

(There

are no

`standards', _{forinstance,for}

physicians.)

Similar

problems

beset

a

definition

of physical therapy-but the most major

is

not to

delimit

the professiontoo tightlyand stifle growth. But again

it

is

a subject that an

international

body

must

tackleand

Pirkko

Kuurne, whose task it

is,

isalso

here･to

talk toyou.

That Physical Therapists should all receive a

four _year ttniversity levelcourse is`encouraged' _by

the

Confederation,

to

be

aspired to-but cannot

jeop-ardise countries where the education

does

not

achieve this

level.

Declarations

and

Studies

The Executive Committee isalso working on

in-ee

2o

geg

7

ternationaltopicaiissuesinphysical therapy

-･interaction

with other

health

care _{professionals}

-the

role of taidesl

mid levelworkers,

tation

specialists

-physical

therapy and AIDS

-specialisation.

All

these are

issues

which are currently

being

tackled nationally. The Executive's task isto

termine whether _guidance can be _given at an

national levelon these and other similar issues,in

order to

help

national

bodies.

Conclusion

I

hope

I

have

been

able toshow you a

little

about

what

international

cooperation can achieve. Let

me conclude

by

saying that

it

is

not always easy

but very rewarding. The _problems are those of

tance, communications, language, cultural

diversity

but

when _you see

Physical

Therapists

from

54

very

different

countries cooperating and working

gether to achieve _growth of thisvery

important

and very respected _profession,then

it

is

a

_personal

joy

and privilege to

be

your

Secretary

General.