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Peshawar, Pakistan  12-13 November 2019

The Flying Faculty of WFNR was invited to give a two-day course on Neurorehabilitation as part of a series of conferences organized in Peshawar/Khyber Pashtuna/Pakistan, November 12 – 16, 2019,  the annual meeting of the Pakistan Neurosurgical Society and ICRAN – International Conference on Recent Advances in Neurotraumatology, by the WFNS Committee on Neurotraumatology. In parallel with this course other teaching courses were also held in the compounds of Northwest Medical School e.g. Course on Clinical Methods, on Brachial Plexus and Nerve Injury, Interventional Neuroradiology in neurotrauma, and a course of Global Neuro Essentials for Neurotrauma.

Despite the number of courses given parallel to Neurorehabilitation, this two-day course attracted more than 150 attendees, who received a certificate at the end of the course.

The faculty consisted of Drs. Bazo, Pistarini, Tonin, Wasti and Mehdorn x2. Dr. von Steinbuechel was unable to attend because of personal reasons but gave her slides to be presented.

All faculty members were enthusiastic about the teaching, and all delivered excellent lectures on their respective fields of particular interest and knowledge – teaching from basic facts to more sophisticated technologies. The Faculty was able to cover the most important fields of neurorehabilitation and conveyed the message that Neurorehabilitation is essential also – and particularly - in these middle and low income countries.

The audience consisted mostly of students of physiotherapy of various levels (bachelor and higher) but also a lot of doctors of physiotherapy and some neurologists and neurosurgeons.

A physiotherapy student receiving her certificate

Although they were at various levels of knowledge, they understood the main messages so that they could be helped to see more sense in their learning and their future profession – e.g. balancing the need of physicians’ guidance and physio-/ergotherapy importance.

At the same time, listening to the local speakers who also delivered excellent lectures and were very cordially received by the auditorium, the Faculty learned a lot about the local facilities: Most patients are treated only in an acute fashion and then sent home being left alone. There's only one probably excellent military rehabilitation institution with very limited access for the non-military population. Even the very well-equipped Aga Khan University Hospital in Karachi does not have a rehabilitation unit included.

On the other hand, there is a Paraplegia Center in Peshawar which has a very peculiar history: It was instituted by the International Committee of the Red Cross during the war in Afghanistan in the 70s and was abandoned at the end of the war. It was given back its original destination in the early 90s; it is the only spinal cord injury center in Pakistan and also cares for patients coming from Afghanistan.   Drs. Bazo, Pistarini, and Mehdorn x2 went to visit at the end of the conference on November 14 and spent many hours discussing with the principal and his staff areas of mutual interest and to learn how this problem is dealt with in Pakistan. The Faculty as very much impressed by the possibilities and the development they have made over recent years, and will certainly try to help them in the future.

Tentative plans have been discussed intensively with Dr. Bazo to cooperate. Similarly, Dr. Mehdorn joined the group invited to discuss neurosurgical/neurorehabilitation needs in cases of mass casualties with the Commander General of the Region. A medicopolitical task for the future will certainly be to overcome the gap between acute neurosurgery/neurology/orthopedics and neurorehabilitation- so far both areas seem to live very separate lives.

Needless to mention the Faculty was very much impressed by the great Pakistani / Pashtuni Hospitality and organizational skills: They were taken from and to the airport on time as requested, were housed in the Five Star Hotel Pearl Continental in Peshawar, were brought to and from the conference site, the Northwest Medical Campus, by a police-escorted bus. In addition, those who had scheduled departures a little later, were taken to a very interesting tour to historic Peshawar – needless to say great Pashtuni dinners, as well as a tour to Khyber Pass following ICRAN and even Hindukush area – Chitral valley.

Maximilian Mehdorn, Anne-Sophie Mehdorn

It was a great learning experience for all of the Faculty and they definitely think they can bring some knowledge on Neurorehabilitation to the peoples of Peshawar and Northern Pakistan. Int the end, they would like to thank the WFNR Presidium to have supported our Flying Faculty to Peshawar, and we hope to be of further help in other parts of the world as well, to promote neurorehabilitation to the benefit of the patients in need. 

Flying Faculty:

Humberto Cerrel Bazo, Anne-Sophie Mehdorn, Maximilian Mehdorn, Caterina Pistarini, Paolo Tonin, Sabahat Asim Wasti