Have you ever wondered what it's like to practice physical therapy in another country? Our PT colleagues are all over the world and we can certainly learn a thing or two from our friends outside the US. We sat down with Sixbert Habimana to learn what it's like to practice PT in Rwanda. Read on for a global perspective of our amazing profession!
1. What is your name, where do you live, where did you attend school, and what year did you finish?
I am called Sixbert Habimana. I live in Kigali/Rwanda. I graduated in 2006 with an advanced diploma in Physiotherapy from the Kigali Health Institute (KHI). In 2015, I received a bachelor's degree with honors after a 1.5-year bridging program at the University of Rwanda (UR) College of Medicine and Health Sciences.
2. What made you become a PT? What type of education is required to be a PT in Rwanda?
A STRANGER MADE ME CHOOSE PHYSIOTHERAPY....
When I was in my last year of secondary school, there were few public universities. When it was time to fill out forms to choose where I would go for university studies, I remember I chose one university twice: National University of Rwanda (UNR at that time, but later became UR). I chose Kigali Health Institute once. I really wanted to go to UNR to study Pharmacy or Agronomy. I was really optimistic that I would get into UNR and that is why I chose it twice.
Some of my friends encouraged me to go for environmental health sciences because they thought it would be easier for someone who had studied the sciences in secondary school. I was also convinced that this was the solution because of my background in biology and chemistry, but I met an old man that convinced me to study physiotherapy instead. At that time, only those that had studied sciences (biology, chemistry, math, physics) were admitted into physiotherapy. I don’t know the requirements to be admitted today.
And how did a stranger made me become a PT? During one holiday, I went to visit a friend in the southern province of my country. On the bus going back home, an old man with gray hair sat by my side and became interested in the book I was reading. He then asked me if I was a student. With confidence (because I succeeded on my national exam and had received a government scholarship), I told him that I had I finished my studies. He was surprised and said "really?!". He then told me that he was sure I hadn't finished my university studies.
The old man went on to ask me if I planned to continue on to university and what I was planning to study. I told him I would study environmental health sciences at KHI. He seemed only somewhat satisfied with my answer and then asked me if there were any medical/surgery related programs at KHI? I told him that if I didn't enroll in environmental health sciences, then I could study physiotherapy. The old man got excited about physiotherapy and encouraged me to pursue PT instead of environmental health sciences.
3. What is your official title in Rwanda? (PT? Physio? Physiotherapist?)
In Rwanda, and I think all over the world, our official title is PT. However, unlike the USA where PTs are called physical therapists, in Rwanda, we are called physiotherapists/physios. This is the title in many, if not all, African countries.
4. What is it like being a PT in Rwanda?
Being a PT is a great honor in Rwanda. Our profession is as noble as general medicine. However, it is not well known here, especially in rural areas. Regarding the general daily tasks, it depends on where one is working. I have worked in 3 different settings and the tasks I had when I was working at a center for people living with disabilities differed from the ones I had when I worked in the district hospital and of course, differ from the sports field where I work now.
PTs are often present across the healthcare spectrum in Rwanda. We are part of the rounding medical staff in the wards of admitted patients, we are involved with research committees of hospitals, and we are in charge of outreach programs. You will also find PTs that are part of accreditation committees.
PTs’ interaction with other healthcare professionals in Rwanda is still questionable. Some of the general practitioners think PTs are there just to massage! Some don’t even make any effort to know what we do. However, they definitely know who we are and what we do when they get back pain or neck pain and have to visit our offices.
The types of treatments PTs use here depend on the condition the patients present with. I think they are almost the same as the types of treatments used elsewhere. In Rwanda, we have pediatric, orthopedic, cardiopulmonary, and musculoskeletal/sports physiotherapy. We also have orthopedic manipulative physios. We mainly treat our patients with exercises, electrotherapy modalities, manipulations, mobilizations, and NDT. We also emphasize patient education as a necessary component of treatment.
5. If someone from here (or outside Rwanda) wanted to practice in Rwanda, is it difficult to get a license?
It is not difficult to get a license to practice in Rwanda for both Rwandans and for those from outside Rwanda. We have an organized allied health professions council that works quite well. There is an amount you will have to pay (less than $100) for your registration and license and then you must submit the required documents. If you meet the requirements, you will receive a license within few days.
6. What are the biggest rewards of your position?
The biggest rewards of my position so far are being called to work as a physiotherapist with different national teams and participating in different sports events on national, regional, and international levels. I worked as a physiotherapist for under-17 and under-20 national football teams. I have also been part of the medical staff for the Kigali Peace Marathon and have assisted with competitions of different sports for the disabled.
7. What are the biggest challenges of your position?
The biggest challenge of my position so far is that I don’t get enough training related to my current field of practice (i.e. sports, mainly football/soccer). The available courses are outside Rwanda and they are very expensive to attend. Additionally, getting enough modern equipment is a problem due to limited resources.
8. Have you practiced in the US, and if so, how does it differ from Rwanda?
I have never practiced in the US.
9. Anything else you'd like to add?
Rwanda already has an association of more than 150 PTs recognized by the World Confederation for Physical Therapy. We are trying to increase physiotherapy awareness across the country through different activities, like car-free day and physio month every September. I hope with time that more Rwandans and healthcare professionals will know what physiotherapy is and what we do.
And finally, a word about direct access. I saw somewhere that this is no longer a large problem in the US, though it may differ from state to state. Here in Rwanda, we don't have direct access to PT, unless someone can afford to pay for 100% of his or her care in a private facility. Patients with insurance require a transfer from a medical doctor in order to come to a PT department.