**Author details**

are financially unstable there is a failure in affording necessary health and rehabilitation services. Even in countries where there may be exemption (after thorough social assessment) for persons who cannot afford hospital bill, the challenge remains on getting to and being admitted in such hospital in the first place. A recent study in Uganda reported that among the difficulties faced by individuals with trauma included inability to attain and afford transport to the hospital and pay for treatments. For this reason, they had to rely on social support from

Injuries resulting from traumatic forces may recover fully or leave the individual with either a temporary or permanent disability. Of these three possible outcomes, permanent disability is most costly to the individual and immediate family. This cost is due to the fact that persons with permanent disability require health-sustaining and rehabilitation services including assistive devices throughout life. Such devices are necessary for them to carry out activities of daily living, pursue a career, and engage in their communities. Essential assistive devices range from relatively affordable hand sprints (for activities of daily living) to more expensive wheelchairs which are a prerequisite for mobility and function. Majority of individuals with severely lower limbs impairments such as total paralysis are left with no other means of mobility except a wheelchair. Unfortunately, essential assistive devices are either unavailable or unaffordable in most rural and semi-urban inhabitants of the LMICs. Again, the burden affording assistive devices is also left to the person and/or immediate family who (in most cases) cannot cover the entailed cost [65]. As a result, a majority of disabled persons lack assistive devices or obtain inappropriate one as a donation. Lacking appropriate functional and mobility device leaves the disabled person in a state of dependence in various aspects. Dependence that results from lack of assistive devices adds to the perceived severity of disability [66]. This disability culmi-

nates poverty to the person and affects the whole family particularly the dependents.

Rural and semi-urban regions of LMICs are predominantly characterized by numerous cultural, socioeconomic, and environmental factors for physical trauma. Existence of such factors sets the inhabitants of these regions at higher risk of physical trauma than those living in the city and high income countries. RTAs are the leading cause of trauma in most of these regions as a result of overcrowding of four-, three-, and two-wheeled motorized and nonmotorized vehicles and pedestrians in limited road spaces. Added factors for RTAs in these regions are: common drunk-driving and speeding behavior and infrastructure deficiencies such as lack of road lights and signs. Fall from trees and other falls (including falling with a load on the head) are other significant causes of physical trauma in these regions. Uniquely, these falls are precipitated crucial and necessary socioeconomic and cultural activities of the people making it complex to reduce incidents of tree climbing. Children sustain not only burn injuries, but

The majority of persons who sustain trauma in these regions are haphazardly handled and transported to health facility by laypersons hence increasing risk of secondary trauma and prehospital death. Evacuation, transport to health facility, management, and future rehabilitation

close relatives and friends [64].

76 Current Issues in Global Health

**6. Conclusions**

are also common victims of fall from trees.

Haleluya Imanueli Moshi1,2\*

\*Address all correspondence to: luluwayesu@gmail.com

1 Kilimanjaro Christian Medical Center, Faculty of Rehabilitation Medicine – Physiotherapy, Moshi, Tanzania

2 Faculty of Medicine, Department of Community Medicine and Rehabilitation – Physiotherapy, Umea University, Sweden
