56 REPORTS N A T IO N A L E X E C U T IV E T he ma in atte nti on o f the Na tio nal Executive Co m m it te e in recent m o n t h s has been dire cted to w a r d s m ea n s o f achi ev ing th e objectives o f the So ciety which were a d o p t e d at th e 16th M eet in g o f the N a t i o n a l Council. A l t h o u g h m a n y o f these objectives are lo n g - te rm in n at u r e, c on si d er a bl e progr ess has been made. S cop e o f P ractice T h e or ig ina l re g ul at io n s defi nin g the Sc ope o f the Profession o f Ph y si ot he ra p y were Gazetted in N o v e m b e r 1974 a n d the revised vers ion, w hic h differed very little f r o m the original, in D e c e m b e r 1976. O ve r th e years it has b ec om e ev id en t t h a t th e Scope, as G az e tte d, does n o t fulfil its fun c tii on — th a t o f an e x p l a n a t o r y s t a te m e n t which has thr ee essential p u r ­ poses • to outlin e the aims an d objectives o f a profe ssi on • to describe the types o f service which t h a t profession is qualifed to pr ov id e • to p ro v i d e a f r a m e w o r k which allows lat it u d e for prof ess io nal m o v e m e n t an d deve lop m ent . Su gge st ion s fo r a newly-defined S cop e o f Practice will, by th e da te o f p u b li c a ti o n o f this J o u r n a l , have been discussed by th e N a t i o n a l C o m m i t t e e o f R e p r e ­ sentatives. T h e fin al ve rs io n will be p re s en te d to the 17th M eet in g o f the N a ti o n a l C o u nc il in A pril 1987 a n d , if a p p r o v e d , will be su b m it te d to the Prof ess io nal Bo ard fo r Ph y si ot h er ap y . C areer a n d salary stru c tu re T he rec en t a cr o s s - t h e - b o a r d 10% increase gr a n t e d to all public servants is reg arded as b ut an inte ri m measure, and th e Society is c o m m i t t e d to th e pri nciple o f di f­ f e r e n ti a ti o n a n d a d e q u a t e r ec o gn it io n o f the p h y s i o ­ t h e r a p y pro fe ssi on . As u su al , very late w a r n in g was received fr o m the S ta te re ga r d in g the m os t rec ent inves­ ti ga tio n by the C o m m i s s i o n fo r the A d m in is tr at io n . T h e Society was, h ow eve r, in the po si ti o n o f being able to p r o d u c e a c o m p r e h e n s i v e m e m o r a n d u m in time fo r the me et in g betw een th e M in ist e r o f H e al th a n d re p r e­ sent ati ves o f the C o m m i s s i o n fo r A d m i n i s t r a t i o n , du e to be held o n 14 A pri l 1986. T h e c o m p i l a t i o n o f this m e m o r a n d u m was m ad e easi er as a res ul t o f th e w o rk o f the v ar i o us po rt fo li o hol der s o n the N a ti o n a l E xecutive C o m m it te e , in p a r ­ ti c u la r th os e p o r t f o li o s falling u n d e r the R e m u n e r a t i o n C o m m it te e , which is a S u b - C o m m i t t e e o f th e N .E.C. Since the re seems to be a c er ta in degree o f c o n fu s io n Fisioterapie, M ei 1986, d e e l 42 no 2 C O M M IT T E E R E P O R T re g a r d in g the role o f p o r t f o li o holde rs , a few w o rd s o f e x p l a n a t i o n m ay be worthwhile. A t the 16th N at io n al C oun cil Meet ing a n A m e n d m e n t to th e C o n s t i t u t i o n was pass ed , pr o v i d in g fo r n o m i n a ­ ti o n a nd election o f N a ti o n a l Executive C o m m it te e M e m b e rs wi thi n c e rt ai n cat egories. In this way it is h o p e d t h a t all m a j o r p h y s i o t h e r a p y interests will gain r e p r e s e n t a t i o n on the N .E .C . Because this c a n n o t be imp lem ent ed until the next elections at the 17th Nation al C oun cil Meeting, mem ber s elected to the pres en t N .E.C. were al lo c at ed c er t ai n po rt fo li o s ac c o rd i n g to their interests and expert ise. M o s t o f these p o rt fo li o s fall u n d e r th e aegis o f o n e o f tw o c o m m it te e s — the E d u c a t i o n C o m m i t t e e or the R e m u n e r a t i o n C o m m it te e — an d th ei r hold er s are th e re fo re m e m be rs o f the respective comm it tee . T h e R e m u n e r a t i o n C o m m it te e consists o f the holders o f th e p or t fo li o s o n c a re e r st ru c tu r e, salaries, S ta te and P r o vi nc ia l H o sp ita ls , special sch ool s and p r iv a te p r a c ­ tice. T h e role o f po rt fo li o -h o l d er s an d th ei r p a re n t c o m m i t t e e s ho ul d n o t be co n fu s ed with the role o f the Special Int erest G r o u p s / A s s o c i a t i o n s o f the Society. T he G r o u p s re pr ese nt the interests o f th e ir mem ber s a nd are c o n c e rn e d with the p ro vi si on o f q u a lit y care within th e i r interest area. T h ey c an m a k e r e c o m m e n d a ­ ti ons to o r r eq u es ts o f the Soc iet y — via th e N a ti o n a l E x e c u t i v e C o m m i t t e e , t h e N a t i o n a l C o m m i t t e e o f R ep re se nt at iv es o r the N a ti o n a l C o u nc il — b u t they hav e no exe cutive fu n c t io n unless so au th o r iz ed by the N .E .C . o r by Council. T h e p o r t f o l i o hold er s ar e res po ns ib le fo r co rr ela ti ng i n f o r m a t i o n fr om all sources, inclu din g rele van t Special Int erest G r o u p s , a n d su b m it ti n g d a t a a n d r e c o m m e n d a ­ ti o ns via th ei r p a r e n t c o m m i t t e e to the N .E .C . for im p le m e nt a tio n. E d u c a tio n a n d sp ecializatio n P o rt fo li os falling u n d e r the E d u c a t i o n C o m m it te e are th os e o n u n d e r g r a d u a t e ed u c a t io n , po st -g ra d u a t e e d u c a t i o n , c o n t i n u i n g p h y s i o t h e r a p y e d u c a t i o n and research. A t t e n t i o n is being focused o n the e d u c a t io n a l p r o ­ cesses re q u i re d in o r d e r to satisfy the ph y si o th e ra p y needs o f the whole c o un tr y . A se p a r a te p o rt fo lio has been esta bli she d in o r d e r to a t t e m p t to es ti m ate the needs o f dif ferent c o m m un it ie s . P la n n i n g will be based u p o n the following as su mp ti ons : R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) Physiotherapy, M ay 1986, vol 42 no 2 57 1. T h a t i n d i v i d u a l s s h o u l d be e n c o u r a g e d to t a k e responsibility fo r m a i n ta i n in g their o w n health. 2. T h a t s u p p l e m e n t a r y h e a lt h pe rs o n n e l need to be tr ai n ed to serve the co m m u n it ie s in which-they live. 3. T h a t m o r e black and co lo ur ed su p p l e m e n t a r y health p er s o nn el are urg en tly n eed ed, an d will be needed in increasing n u m b e r s in years to come. 4. T h a t m o r e h e a l t h se r v ic es s h o u l d b e c o m e c o m ­ m u n i ty - b a s e d and geared t o w a r d s th e needs o f th a t co m m u n it y , which are m os tly th ir d -w o rl d needs. 5. T h a t dif ferent types o f p h y s i o th e ra p y expe rtise will be nee de d to s u p p l y these needs, a n d t h a t tr ai n i n g cours es m u s t be st ru c tu r e d a c co rd in g to the c o m p e ­ ten ci es w h ic h th e new ly q ua li fi ed p h y s i o t h e r a p y p r a c t i t i o n e r — be he pr of ess io nal ly o r practically orie nte d — will need to develop. At p o s t - g r a d u a t e level, m u c h a t t e n t i o n is being given to th e possibilities fo r specia li zat io n. A m e m o r a n d u m su b m it te d to th e N . E . C . in M a r c h is being discussed by the N a ti o n a l C o m m i t t e e o f R epr ese nt ati ves in May. Possibilities incl ud e f o r m a l p o s t - g r a d u a t e degre e p r o ­ g ra m m e s ( m a n y o f which al r ea d y exist), th e c re a t io n of Fell ow sh ip a w a rd s (possibly a d m in is te re d by a College o f P h ys io th er ap is ts ) and the m o r e p r o b l e m a t ic a l system o f certif ica tio n o f clinical com p et en c e. A lt h o u g h there is n o d o u b t t h a t sp ec ia li za ti on is de si ra bl e , its legal im pli cat io ns as well as li mi tat ion u p o n m e m b e rs o f the pr of ess io n m u s t also be investigated. T h e So ciety has also recently, at the re q u es t o f the D e p a r t m e n t o f N a t i o n a l H e al th an d P o p u l a t i o n D e v e ­ l o p m e n t , revised the list o f q ua lif ic at io n s recogni zed by th e C o m m i s s i o n fo r A d m i n i s t r a t i o n an d m o t iv a t e d for b et t e r fi nancial r e c og ni tio n o f ad d it io n a l registrable qu ali fications. P ro gr es s re g ar d in g th e re s ea rc h p o rt fo li o is r e po r te d on elsewhere in this issue. T h e Y ear o f th e D isab led P e rso n 1986 has be en de si gn ate d as th e N a ti o n a l Ye ar o f the D is ab l ed P er s o n, falling within th e D ec a d e o f D isa bl ed P e rs o n s as p ro c l a im e d by th e United N a tio ns . T h e S oc ie ty has u n d e r t a k e n to p r o m o t e this a t local and n a t i o n a l level, and Back Week this year will be directed t o w a r d s t h e c o u n s e l l i n g o f c a r e t a k e r s o f d i s a b l e d people. A d m in istra tio n a n d F in a n c e T h e Society is still see king su it ab le prem ises in which to h o u s e its S ec re t ar i at . T h e a p p o i n t m e n t o f a p e r m a ­ ne nt S ecr et ary is also receiving att ent io n. S.I-C. R E P O R T O N A T T E N D A N C E A T T H E S IX T H IN T E R N A T IO N A L A C U P U N C T U R E S E M IN A R IN H O N G K O N G A N D A C U P U N C T U R E S T U D Y T O U R O F M A IN L A N D C H IN A IN O C T O B E R 1985 In A u g u st 1985 1 was invited to pres ent a p a p e r at the S ixt h I n t e r n a t i o n a l A c u p u n c t u r e S e m i n a r to be held in H o n g K o n g f r o m 6 - 8 O c t o b e r 1985. This s e m in a r is an a n n u a l even t orga ni sed by the I n t e r n a t io n a l A c u p u n c ­ ture Society. W h e n 1 acc epted the in vi ta ti on I also registered fo r a s h o r t a c u p u n c t u r e st u d y t o u r o f m a i n ­ land C h i n a which was also orga ni sed by the above Society. T h e S e m i n a r was held at the h e a d q u a r t e r s o f the H o n g K o n g Medi cal A sso ci a tio n and ther e were dele­ g a t e s f r o m m a n y p a r t s o f th e wor ld in c lu di n g United K ingdom, United States o f America, C a n a d a , Australia, New Z e a la n d , Ind ia , E gy pt and J o r d a n . M o s t o f the delegates were med ica l d o c t o r s an d I was o n e o f two phy si o th era pi st s the o th e r being fr o m A ustralia. T he p a p e rs read a t the s e m in a r were m o s t interesting and varied an d inc luded the use o f a c u p u n c t u r e a n d / o r its va ri an ts in the m a n a g e m e n t o f psych ia tri c disord ers (D r. C. Y u n g Ass oci ate P ro fe sso r, Un iversity o f Texa s, U . S . A . ) , a c u p u n c t u r e f o r d r u g a d d i c t i o n ( D r . R. A lex an de r, H o n g Kong), the use o f a c u p u n c t u r e in o p h th a l m o l o g y ( D r R. C hin g, H o n g Ko ng), t r e a tm e n t of bronchial a s t h m a using ac u p u n c t u re (D r. P. L am ori a, India), effects o f a c u p u n c t u r e o n b lo o d ch o les ter ol and li p id s ( D r . A. K u m a r , I n d i a ) , t h e a p p l i c a t i o n o f ac u p u n c t u re and a c u p re s s u re in ph y si o th e ra p y (M rs. P. T a m , S e ni o r L ec tu r e r in P h y si o th e ra p y H o n g K o ng Polyt ech nic ), the c o n n e c t io n betw een a c u p o in t s and vis cer a t h r o u g h skin t e m p e r a t u r e (D r. L. Hu i La n, Z h o n g s h a n Medical College, C h in a ) and painless la b o u r (D r. D. Ha ide r, India). My p a p e r was enti tl ed “ A Clin ical R e p o r t o n the use o f A c u p u n c t u r e in the m a n a g e m e n t o f A m p u t a t i o n S t u m p P ai n a n d P h a n t o m L im b P a i n ”. T hi s p a p e r p re s en te d a n a p p r o a c h to a m p u t a t i o n s t u m p p a i n w h i c h 1 h a v e d e v is e d , a n d th e r e s u lt s o b t a i n e d f r o m tr ea ti n g 20 a m p u t e e s referred fr o m the King E d w a r d V III H o sp it al A m p u t a t i o n R eh a b il it a ti o n Clinic. T h e subj ect was well received and gave rise to c o n s i d e ra b l e di s cu ss i o n , as it did la te r w h e n d e b a te d in Ch ina . T h e s t u dy t o u r o f C h i n a c o m m e n c e d o n O c t o b e r 9 with a tw o d a y st ay in C a n t o n ( S o u t h C h in a) . T he m a i n f e at u re in C a n t o n was a visit to th e Z u n g S h a n H o sp it a l where o p e r a t i o n s usi ng a c u p u n c t u r e a n a e s ­ thesia were observed. T w o cr a n i o to m ie s (fo r r e m o va l o f ce reb ra l t u m o u rs ) an d th r ee t h y r o id e c t o m i e s were observed. A n ae st he s ia ( p r o f o u n d analg e sia) was o b ta i n e d in e ac h case by the ap p li c a ti o n o f e le c tr o - a c u p u n c tu r e ( i n te rr u p te d direct c u r r e n t o f 30 H ert z) using two stainless steel needles. Pa ti e n ts had been p r e p a r e d by a d m i n i s t r a t i o n o f a mild sedat ive an d o m n o p o n o r sco p o l am i n e as a p re - m e di ca ­ tion. T h e pa ti e n ts r em ai ne d c o ns c io us t h r o u g h o u t the o p e r a t io n an d it was possible to converse with them. R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) 58 Fisioterapie, M ei 1986, deel 42 no 2 A fte r th e session in th e o p e r a t i n g th e a t r e , lo n g d is ­ cuss ion s were held with th e C h in ese an ae st he ti sts and s u r ge on s an d th e c o n cl u s io ns d r a w n in resp ect o f a c u ­ p u n c t u r e a n a e s t h e s i a were, t h a t it was given to patie nts w ho re q ue s te d it an d to t h o s e o f a ca lm d is p os it io n. Its use was restricted mai nly to o p e r a t io n s ab o v e the plane o f Louis. C os t was n ot a fa ct o r in giving a cu p u n c t u re a n a e s t h e s i a as m o d e r n an ae st he ti c a p p a r a t u s and well tra in ed anae st he tis ts were available. T h e n ex t th r ee d ay s o f th e t o u r were sp e n t in H a n g ­ z h o u where m or e surg ical p r o c e d u r e s involving a c u ­ p u n c t u r e a n a e st h e si a were obs erved. It is n o te w o rt h y t h a t at H a n g z h o u H o sp it a l 5 0 0 0 c r a n i o to m ie s ha d been p er fo rm e d u n d e r a c u p u n c t u r e a n a e s t h e s i a between 1975 a n d 1979. As well as th e su rg er y at th e H a n g z h o u H o sp it a l a wide ran ge o f a c u p u n c t u r e p ro c e d u r e s was as d e m o n s t r a t e d . A c u p u n c t u r e was ma in ly used fo r the m a n a g e m e n t o f pa in fu l m u s c ul o sk e le ta l co nd it io n s , sinusitis, gastritis, migraine and o the r for ms of headache. (N.B. th e W o r l d H e a lt h O r g a n i z a t i o n has en d o rs ed th e use o f a c u p u n c t u r e in th e fol lowing con d iti on s: leg ulcers, migra in e, cepha lgia , sinusitis, tr ige m ina l n eu ­ ralgia, ve rtigo, he rp es zo ster, neur al gia , pare ses, dys- m e n o r r h o e a , b r o n c h i a l a s t h m a , colitis, a m e n o r r h o e a , d u o d e n a l an d peptic ulcer). T h e last tw o d a y s o f th e t o u r were sp e n t in S h a n g h a i w her e f u r th e r a c u p u n c t u r e p ro ce d u r es were observed at th e m a j o r te a c h in g h osp it al a tt ac he d to th e University of Sh an gh ai . As well as th e a ca de m ic p r o g r a m m e a b ri e f b u t fas ci n at in g insigh t int o th e cu lt u ra l life o f C h i n a was o b ta i n e d . M a n y signs o f em er gi ng ca p ita li sm were evi­ d e n t a n d C h i n a is n ow o p e n to a massive t o u r is t t r a d e p a tr on is ed main ly by A m er ic an s a n d J ap an es e. M ed ic in e in C h i n a is a n in te re st in g blend o f the tr a d i t i o n a l and Wes tern . All th e hosp ita ls visited had m o d e r n (W es te rn st a n d a r d ) dia gn os ti c an d tr e a tm e n t facilities; and all h ad their tr a d it io n a l sections (a c u p u n c ­ tu re , h e rb a l medicine, etc.). T h e im p re ss io n was gained th a t th e tr a d it io n a l a p p r o a c h is still the m os t p o pu la r . T h e s e m in a r an d t o u r pro v id ed a s t im u la ti n g ex p er i­ ence fo r me. I was ab le to le ar n several dif fer ent a p p r o a c h e s to a c u p u n c t u r e . I have be en able to i n c o r ­ p o r a t e the se in my p ra c t ic e in K in g E d w a r d V III H o sp it a l an d in th e P a in Clinic at A d d i n g t o n Ho spi ta l. T h e te c hni qu es hav e alr ea d y bee n t a u g h t to a n u m b e r o f p h ys i ot he ra p i st s w h o are int erested in this ad d it io n a l m e t h o d o f pain m o d u l a ti o n . A cknowledgem ent Th ank s are expressed for financial assistance from the Sou th African Society of Physiotherapy and two col; leagues. C. A. Liggins Senior Lecturer, Physiotherapy Department, University of Durban-Westville/Natal Provincial Administration. Try New Flotation Pads to keep you free from bedsores N ow “N E W B O N M A T ” and “ N E W P A R A M A T ” com e up with b etter quality yet low er prices than conventional flotation pads rtrris) Rand Medical Supplies R andburg C entre 449, Jan Sm uts Ave., B lairgow rie, R andburg 2194 Box 7166, Jo h annesburg. Tel. 7 8 9 -2 2 0 3 /7 8 9 -2 2 8 6 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. )