Prior to the turn of the 19th century individuals with lesser physical capacity from congenital diseases or acquired from work accidents, war wounds, etc., were commonly excluded from work and social environments because they were considered incapable of contributing to society. Medical care for this type of population was seen as a charitable phenomenon.
In the latter 19th century liberal Mexican governments began to recognise individual rights and included principles of equality and inclusion, and the productive dynamics of society into their political ideology. The demand for medical attention for specific therapies such as physiotherapy, occupational therapy and prosthetics accelerated with the recognition of rehabilitation. And the concepts of functional recovery and social re-adaptation were incorporated into health care. The creation of the School for the Deaf and Mute in 1866 and the National School for the Blind in 1870 provides an example.
Addressing the needs of the vulnerable population ceased to be a moral obligation, and the government initiated a series of actions for the recognition of the rights of these individuals. In the National School for the Blind, blind people were taught massage and physical exercises. Although the figure of physiotherapist didn’t exist by that time, massage and exercise was considered a good modality of treatment. It is also important to mention that later in time, blind people are still known as good masseuses. Unfortunately however, there a misconception persists that physiotherapists and masseurs do the same thing, possibly stemming from the belief that massage is the only therapeutic tool the physiotherapist have.
The Colonia Hospital, in México city was founded in 1892. It provided medical services to railway workers who had suffered work-related accidents. This hospital had many neurological (spinal cord and stroke) injures and amputee patients.
Social and political events like the Cananea miners strike in 1906 highlighted the need to improve working conditions in the mines, where there were many workplace accidents that caused disability or invalidity among the workers. This situation laid the groundwork for the first initiatives in occupational medicine in Mexico. Early physiotherapy was provided by nurses.
In 1905 the Hospital General de México was the first modern hospital in Mexico. Its design embodied the maxims of European hygienism which favoured the pavilion type of architecture to facilitate natural ventilation and lighting. It included a physical medicine and rehabilitation department that included modern European services of hydrotherapy, mechanotherapy, and electrotherapy. It was unique in Latin America and subsequently Hospital General de Mexico is known as the cradle of Mexican rehabilitation.
The Real del Monte Hospital in Pachuca, founded in 1907, was one of the first hospitals to integrate orthopedics, occupational medicine, and rehabilitation. This hospital (now a museum) attended patients that worked on the mines, and still preserves the first splints for hands, feet, and spine, which were used to stabilise fractured segments.
The rehabilitation service of the Federico Gómez Children’s Hospital was inaugurated on its opening day, 30 April 1943. This was the breeding ground for great doctors who contributed to the formation of other rehabilitation centres, such as Dr Ibarra, who later became the director of the National Rehabilitation Institute. Currently this is biggest and most important rehabilitation centre in Mexico city, and includes a physiotherapy and occupational therapy school.
The National Institute of Cardiology was one of the first services to have a cardiac Rehabilitation department, whose head was Dr Nicandro Chávez, who was a pioneer in training doctors in the specialty of cardiac rehabilitation. The National Institute of Cardiology offers the specialty of cardiac rehabilitation to physiotherapists and is one of the few postgraduate courses for physiotherapists.
The Central Military Hospital and the American British Codwray Hospital had a rehabilitation service managed by nursing staff who had training abroad in rehabilitation and physiotherapy
The Mexican Institute of Rehabilitation was, in its time, one of the most important rehabilitation centres in Latin America. The operational model of the Institute through multidisciplinary work transformed the concept of rehabilitation into the inclusion and labour re-adaptation of rehabilitated patients. The Mexican Institute of Rehabilitation was also one of the first five schools to offer technical courses in physiotherapy and occupational therapy, while providing rehabilitation services and having technicians in the manufacturing of orthoses and prostheses.
The National Medical Center (CMN) of the Mexican Institute of Social Security was inaugurated in 1963, which included physical medicine and rehabilitation services at the Traumatology, Orthopedics, and Rehabilitation Hospital and at the Pediatrics Hospital of the CMN.
In 1971, the National Rehabilitation Program was established. The Musculoskeletal Rehabilitation Center changed its name to the National Institute of Rehabilitation Medicine, Audiology, and Human Communication, forming a rehabilitation centre where therapies such as physiotherapy, occupational therapy, orthotics and prosthetics, and speech therapy were applied. Starting in 1975, the school for Rehabilitation Technicians of the Ministry of Health (SSA) was established at the Musculoskeletal Rehabilitation Center, incorporating technical programs in physiotherapy, occupational therapy, and orthoprothesis. Years later, it became the National Rehabilitation Institute, a name it still holds to this day.
For its part, the Mexican Social Security Institute (IMSS) created the IMSS National Rehabilitation Center for Work in Metepec, Puebla, which was inaugurated on April 26, 1982, to rehabilitate workers. These rehabilitation centres contemplated integrating an interdisciplinary team with different professionals such as physiotherapists, occupational therapists, orthoprothetists, social work, psychology, speech therapy, etc., which strengthened the practice and multidisciplinary work.
References
Morales Cosme AD & Rodríguez Pérez ME. (2023). Historia de la terapéutica en México: Recursos, tratamientos y procedimientos, México. Departamento de Historia y Filosofía de la Medicina, Facultad de Medicina, UNAM, 2023. (Monografías de Historia y Filosofía de la Medicina, 10).
