The doctor also emphasized the importance of taking patients who suffered from a stroke or trauma following a traffic accident to a rehabilitation hospital right after they received medical treatment. This avoids missing the “golden period” in which they can be saved.
In an interview with Arab News, he said: "In cooperation with Northern Ireland University, our hospital has started to use upper-limb electronic technology, which consists of prosthetic limbs that the patient can use by moving the muscles in the remaining amputated part."
Another thing he discussed in the interview is the difference between rehabilitation medicine and physiotherapy, an oft-repeated question.
“Physiotherapy has been founded as a profession a long time ago, and it is a specialty that still can be found in some hospitals that do not have medical rehabilitation facilities. It is a means of medical rehabilitation, with other disciplines falling under it, such as occupational therapy, prosthetic devices, communication therapy, swallowing therapy, art therapy, recreational therapy, social services, and psychotherapy.”
Dr. Abu-Abah continued: “The rehabilitation medicine field, on the other hand, started to grow after World War II due to the large number of injured soldiers and amputees. Initially, doctors believed it was only for the severely disabled and those who needed continual care. However, they found it to be an effective solution, because it reduces the patient’s hospitalization period, giving other patients the chance to get treated and reducing the patient’s medical bill.
“Gradually, ambulatory care began to contribute to rescuing the lives of patients, although most of them kept their disabilities. In former times, many casualties died on the accident site, because they did not receive first aid. Nowadays, however, trained paramedics arrive quickly to rescue the wounded from dying, but they might cause disabilities. Hence, although the improved medical services increase patients’ opportunity to stay alive, they have also resulted in a bigger number of disabilities among them. That is why rehabilitation medicine became globally important.”
Dr. Abu-Abah is convinced that the future of rehabilitation medicine in Saudi Arabia is bright after Custodian of the Two Holy Mosques King Abdullah ordered the establishment of four rehabilitation hospitals in addition to the existing hospitals in Madinah and Riyadh. The one in Riyadh, the Rehabilitation Hospital in King Fahd Medical City (KFMC), is considered the benchmark for other hospitals.
“No, it does not interest them for many reasons. There is no training program for it in the Kingdom, and it is not among the courses they study in the medical colleges. As a consequence, the teachers themselves do not have much experience in rehabilitation medicine, and the Saudi Commission for Health Specialties (SCHS) does not have this kind of specialty.
“The Rehabilitation Hospital in KFMC contributed to raising awareness of medical rehabilitation, and in cooperation with other hospitals and specialists they succeeded in convincing the SCHS to develop a training program for doctors, which will start soon. There are other specialties within rehabilitation medicine that are becoming increasingly known, arousing the interest of medical students.
“In Saudi Arabia, there are a large number of Saudi specialists working in the Rehabilitation Hospital in KFMC, whereas we find only two or three non-Saudi specialists. On the other hand, we find there is neither a bachelor’s degree of occupational therapy in the country nor any training program in prosthetic devices and artificial limbs specialty. Moreover, the training program in King Saud University (KSU) for speech, hearing and communication is a very restricted program, graduating a limited number of doctors, so we can come to the conclusion that rehabilitation medicine does not have any kind of educational training programs in Saudi Arabia.
“Nevertheless, we expect the Ministry of Higher Education to initiate rare specialties at Saudi universities, such as occupational therapy, clinical social work, the prosthetic devices specialty, and other specialties the country needs. We, as a rehabilitation hospital in Madinah, spoke with colleagues from the King Abdullah Scholarship Program to suggest some specialties to students who want to study abroad. In cooperation with a foreign university, we are about to start a program for studying the prosthetic devices and artificial limbs specialty after getting official approval from the relevant authorities. We also allow doctors and high school graduates to study abroad to get bachelor's degrees in rare medical specialties.”
“We have a very clear mechanism, and we try to treat everyone equally. We always try to find the right patient at the right time, and we do not have any geographical conditions; we accept cases from any part of the Kingdom. We have a program that allows any other hospital to be a user and enter the electronic program to accept cases, and provide a referral within 48 hours. The program also allows doctors to give a referral to our hospital for any case. Among the acceptance conditions is that the patient should be given a diagnosis and the medical and surgical treatment, and he should be able to comprehend this. By comprehension we do not mean that the patient is verbally able to communicate with others, but he is rather able to receive and respond to what he is asked to do.
“We do not have a long waiting list. The problem we sometimes face is the patient coming too late, so his joints and muscles get stiff beforehand. In that case the rehabilitation does not benefit him in any way. Sometimes, we receive patients in a coma who cannot get the benefit of rehabilitation, because they do not respond at all. I request everyone to send the patients as soon as possible, so we can get the benefit of the golden period, which is usually one week after a stroke and after receiving medical treatment. During this phase we can avoid several side effects and problems. Paraplegic and quadriplegic patients can be saved during this period too, and we can spare them lots of damage.”
“Yes, there are different specialties included in rehabilitation medicine, such as medical treatment.
Sometimes, rehabilitation medicine includes surgical intervention, because the surgery is an important part of the rehabilitation. For example, we might have a case of a patient who has a paralysis in his upper limb, and we want him to use the device controller unit in an electric wheelchair, so he gets a surgery to move a tendon from one part to the other. In that case, surgical intervention is very beneficial to the patient.”
“Unfortunately, we have a high percentage of diabetic and trauma patients in Saudi Arabia. There are many causes of people losing a limb. We must not forget that the Medical Rehabilitation Hospital in KFMC is just an extension of the rehabilitation center in Riyadh, which has been the sole supplier of prosthetic devices in Saudi Arabia for more than 30 years.
“In fact, the center has helped several hospitals in the Kingdom by providing them with specialists to save patients from the trouble of traveling to Riyadh to get a prosthetic device. The center has also made an attempt to cooperate with the health affairs departments in the Kingdom. It has established more than 14 units for prosthetic devices and artificial limbs. The public must be aware that prosthetic devices and artificial limbs vary; there are simple and very advanced devices.
“It is with no doubt that amputating from under the knee differs very much from amputating above the knee. A patient who has his leg amputated from above the knee must have an artificial knee built for him in a similar manner to the original in order for him to live a normal life. Therefore, we try to develop these items in the hospital, and we have finally invented the “smart limb,” which can recognize whether a person is active or not and if he is in need of activities like running and jumping.
“Also, we have included silicon limbs, which are limbs for people who have their arms amputated and are very similar to the original limb. We have collaborated with Northern Ireland University to use the electronic technology for the upper prosthetics. Youngsters are the majority of patients who use this technology for the advantage of gaining a function in their artificial limb rather than having it for appearance.”
“I would like to clarify that medical rehabilitation has three sides: a medical side, psychological side, and social side. Therefore, if we overlook one side, it will cause an imbalance in the triangle and we will gain no result.
“We take care of the psychological side as much as the medical and the social sides, and we allow the patient to integrate inside his society. We have a counselor who pays attention to the psychological matters along with social workers and specialists who work in social rehabilitation. We often take patients on visits to experience how to overcome the obstacles in front of them, such as using the escalator for wheelchair patients. We train them to achieve this goal.”
