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Putting physiotherapy on a global stage

Antony Duttine tells Gill Hitchcock why he’s determined to raise the profile of rehab in his work with an International agency.

It’s a long way from Birmingham to Kandahar in Afghanistan, but that is just one of the remarkable journeys Yorkshireman Antony Duttine has taken during his physiotherapy career.

Mr Duttine is currently a technical adviser in global health for Handicap International, based in Washington – DC not Tyne and Wear - which is also a long way from his home town of Ilkley.

After graduating in physiotherapy from the University of Southampton, he practised at Birmingham’s Moseley Hall Hospital’s brain injury rehabilitation centre.

So why the wanderlust? ‘I had travelled, as a lot of people do in gap years or backpacking. I enjoyed overseas culture, but I wanted to be part of a new culture and community, not just visit,’ he responds.

His first step was an application to Voluntary Services Overseas (VSO). With his physio background and five years’ experience with an NHS community rehabilitation team in Cheltenham behind him, Mr Duttine was accepted and in 2006 VSO posted him more than 7,000 miles away in Namibia.

The British physio spent the following two years working for the southern African republic’s ministry of health in areas heavily affected by HIV, AIDS, tuberculosis and malaria. Facing very different healthcare challenges from those in the NHS, it was a steep learning curve, Mr Duttine recalls.

‘There was quite a lot of adapting and I realised quite quickly that, although I’d spent five years building up and polishing my skills in a UK health system, it’s quite different from the skills you need in a much less-resourced setting with very different health challenges,’ he says.

‘I realised that I needed to do a lot of learning, call on a lot of support. You are thinking on your feet a lot more, and using a lot of more or your clinical reasoning skills.’

In a well-resourced health service such as the NHS, he explains, a patient with an extremely arthritic knee could be a candidate for replacement knee surgery. But in Namibia that option was rare and he focused on helping patients to manage their chronic condition.

One year into his Namibian life, Mr Duttine knew how much he enjoyed the challenge of learning about a different cultures and languages, and opted to follow an Open University masters course in development management.

‘I realised that while I had the skills in physiotherapy, I really had limited knowledge about international development and development management,’ he reveals.

Joining Handicap International (HI) in 2008 was a ‘natural step’ for Mr Duttine, and over the next two years he worked on its extensive rehabilitation programme in war-torn Afghanistan.

‘I started out looking at rehabilitation, by that I mean physiotherapy work but also work in prosthetics and orthotics in Herat and Kandahar,’ he explains.

‘But during my time there I became the broader technical coordinator for our programme, which meant stepping away from rehab a little bit and also doing things like programmes in inclusive education, disability rights and land mine risk education.

‘So that was a big learning experience as well, seeing where rehab fits into a much broader social construct that disability is.’

Since joining HI’s Washington DC office in February 2012, Mr Duttine has focused on raising the profile of rehabilitation and long-term care, often seen as unaffordable luxuries.

A key part of Mr Duttine’s role is to join aid networks and raise awareness about the power of rehabilitation.

When HI delivered rehabilitation services in Haiti after the 2010 earthquake, for example, it found the people coming forward were not only victims of the disaster, but patients with stroke and children with cerebral palsy. He notes that many of those people need long-term physiotherapy, and not just a service established for the duration of an emergency.

Indeed, Mr Duttine emphasised this point at last month’s international allied health professions event in Edinburgh (‘‘Seize the moment’ and press for rehab services, speaker urges’, Frontline, page 17, 23 October).

Asked for advice for British physios with a yen to work internationally, Mr Duttine recommends the CSP’s ADAPT (Chartered Physiotherapists in International Health and Development) network as a first port of call.

ADAPT can help to identify organisations looking to do voluntary work overseas, or building up your portfolio and getting experience. The next step is VSO and potentially HI, although it tends to take people who already have international experience.’

Mr Duttine’s current ‘big push’ is trying to influence the UN’s post-Millennium Development Goals: ‘The challenge is showing how rehabilitation can improve quality of life and is a cost effective strategy,’ he adds. fl

Handicap international

Handicap International is a non-governmental organisation that was set up in 1982 to provide help in refugee camps in Cambodia and Thailand.

It works alongside people with disabilities and vulnerable populations in situations of poverty and exclusion, conflict and disaster.

The charity aims to take action and raise awareness in response to essential needs; improve living conditions and promote respect for dignity and fundamental rights.

Nobel Peace Prize

In 1997 Handicap International was a co-recipient of the Nobel Peace Prize, as a founding member of the International Campaign to Ban Landmines.

Funding

The charity relies on two main sources of funding: donations, private solidarity sponsorship, legacies and sales of craft, fair trade and co-branded products; and grants from public bodies, including the EU and UN and private bodies, such as foundations and companies.

Further Information

 

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