“Before, I felt like a burden. Now, I can do things for myself again. My children see me stronger, and that gives them hope too.”
For Olambi Zaripova, a 41-year-old mother of 4 from the rural Jafr community in Rudaki District, Tajikistan, life changed dramatically after she suffered a stroke following the birth of her youngest child. Without access to rehabilitation services, she struggled to feed herself, move from her bed to her wheelchair or walk without assistance. For years, she relied on her mother for care, while her youngest child remained her only constant companion.
Today, thanks to an initiative of the Ministry of Health and WHO, Olambi receives affordable rehabilitation services close to her home. These services reached her local health centre as part of a pilot project introducing the WHO Basic Package of Interventions for Rehabilitation (BPIR) toolkit.
WHO and the Ministry of Health launched the BPIR project to address the need for rehabilitation services in many low- and middle-income countries such as Tajikistan, where more than half of those in need of critical rehabilitation and assistive technology services lack access to them.
Bridging the gap in rehabilitation care
WHO develops and conducts training on basic rehabilitation to equip primary health-care workers, such as nurses and doctors, with the skills to identify rehabilitation needs and deliver simple, evidence-based interventions, even in areas with few specialized therapists. Globally, the need for rehabilitation is rising due to ageing populations, the growing burden of noncommunicable diseases, and the aftermath of conflicts and injuries.
For nurse Malohat, after attending a 5-day frontline worker training on basic rehabilitation, she was able to visit Olambi and introduce simple exercises and make small changes to her home. By doing so, Malohat helped her patient slowly reclaim her independence.
Today, Olambi can feed herself, move from her bed to her wheelchair, and even walk short distances with a stick and minimal assistance.
“This pilot is a lifeline for communities,” says Dr Victor Olsavszky, WHO Representative in Tajikistan. “When nurses like Malohat are empowered with the right tools, they can change lives – one patient at a time.”
Training local changemakers
As part of the initiative, 4 physical therapists, 13 primary health-care workers and a rehabilitation specialist gained hands-on skills to assess patients and support their independence. Over the 5-day training course, they learned to deliver basic care, including evidence-based exercises and simple home adaptations that are promoted by WHO.
Their experiences and feedback will be crucial in refining the project for broader implementation across Tajikistan and potentially around the world.
However, this project is more than a training course; it is a movement towards a healthier, more self-reliant future for Tajiks and their communities. Empowering people to live more independently and happily doesn’t just improve lives – it also reduces long-term reliance on the health system, decreases caregiver demands, lowers the need for mental health interventions, and ultimately saves both health and social systems significant resources.
The basic rehabilitation training for frontline workers in Tajikistan is built on 8 core rehabilitation needs, focusing on improving patients’ functioning rather than just treating conditions. By integrating rehabilitation into primary health care, where 1 in 3 people may need rehabilitation, the project ensures services are accessible, affordable and sustainable – especially in remote areas where specialists are scarce.
A model for the future
As Tajikistan scales up this initiative, the lessons learned will inform similar efforts in other low-resource settings worldwide. For Olambi and countless others, it’s proof that even small steps in rehabilitation can lead to giant leaps in dignity and hope.
This life-changing work has been made possible thanks to the generous support of ATscale, the Global Partnership for Assistive Technology. ATscale is a cross-sector global partnership with a mission to transform people’s lives through access to assistive technology. By catalysing action and bringing partners together, ATscale is working to ensure that by 2030, an additional 500 million people in low- and middle-income countries get the life-changing assistive technology they need.
Continued and expanded investment from partners like ATscale will be vital to sustaining this momentum and continuing the transformative work of WHO with the Ministry of Health in Tajikistan. This will ensure that essential rehabilitation and assistive technology services reach everyone who needs them, building a more inclusive and hopeful future for all.