Post-Polio Health International (PHI) is a relatively new name for a non-profit organization that officially began its work in 1960. For many years it was known in medical, rehabilitation, and disability circles variously as GINI, or the International Polio Network, or the Rehabilitation Gazette Network, [1] or more familiarly as Gini’s Network, in honor of Gini Laurie, its founder and driving force until her death in 1989. [2]
PHI’s mission is to enhance the lives, health, and independence of polio survivors, as well as those in the cross-disability category of home ventilator users, who are addressed through a subsidiary organization called the International Ventilator Users Network (IVUN). [3] PHI’s headquarters are in St. Louis, Missouri, where it has a small paid staff. Otherwise, it is run by volunteers, including a board of directors and various advisory committees. [4] Financial support comes from donors, sponsors, member/subscribers, and also from a group of “association members” consisting of local and regional polio support groups.
PHI publishes two quarterly newsletters, Post-Polio Health [5] and Ventilator-Assisted Living. [6] It runs a telephone and e-mail answer-line during business hours, responding to requests from polio survivors, clinicians, researchers, and journalists. Its websites are updated almost every business day, and have a searchable archive of information on polio, post-polio syndrome, and independent living. It has recently begun to fund a modest amount of scientific research related to its mission – usually pilot studies, [7] and occasionally to manage research projects for other organizations such as the Christopher and Dana Reeve Foundation. [8] Increasingly, it is addressing the need to organize and fund a digitized archive of information on polio, and living with polio, that is relevant to all neuromuscular disabilities. And it has been working with other organizations to include rehabilitation for polio survivors in the current program for the worldwide eradication of polio.
PHI’s core constituency is in North America, but its networks of polio survivors, clinicians, scientists, and historians have always been widely international. This is true also of its medical and consumer advisory committees (the latter now being explicitly an international committee), [4] attendance at its international conferences, the extent to which it communicates with polio and disability organizations in Europe, South America, Asia, Australasia, and Africa, [9] and the extent to which its work is known by international organizations. [10] PHI also holds a substantial archive of materials on living with polio.
PHI is not itself a support group, but rather a network and resource for such groups. It is not a treatment facility, but rather a directory to such facilities and a reference desk for information about specific polio or ventilator related problems. Its many publications such as its Handbook, [11] its two quarterly newsletters, its informational brochures on the late effects of poliomyelitis (published in Chinese, Persian, French, German, Italian, Japanese, and Spanish), and its occasional formal statements on controversial issues such as physical exercise and on anesthesia for people with neuromuscular disabilities are widely referenced. [12]
After the polio epidemics in the United States ended, the March of Dimes had changed its mission from polio to birth defects; most of the special rehabilitation hospitals and clinics devoted to polio survivors were closing; clinical specialists in polio were scattering. Polio survivors (substantially more in 1960 than the CDC-estimated one million in the US who were still alive in 1995) [13] were often isolated from the support needed to cope with maturing and aging with a significant physical disability.
PHI at first devoted itself to making sure polio survivors could stay in touch with each other as needed, and with clinicians who had special expertise with polio. These efforts evolved into a variety of publications aimed at providing authoritative information on health issues for polio survivors, and on mainstream opportunities for them – as well as for other people with significant physical disabilities – in education, employment, family life, travel, and leisure activities. The organization’s magazine (until 1985), The Rehabilitation Gazette, had those matters as its dominant themes.
By the late 1960s and early 1970s, PHI was also at the forefront of what has come to be called the independent living movement (or as Gini Laurie preferred to call it, the interdependent living movement) and was also involved in advocacy for the US 1973 Rehabilitation Act. Accessibility (of public places, education, governmental institutions, and of transportation and accommodations) was a major theme, as was the development of an effective system of home health care and personal attendants to ensure that people with serious physical disabilities would be able to live in the community of adults rather than as perpetual dependents within families or institutions.
Toward the end of the 1970s, PHI began to receive an increasing number of reports from polio survivors of new symptoms – a constellation of fatigue, decreased endurance, increased muscle weakness and pain – that sounded like a repeat of some of the early symptoms of poliomyelitis, or perhaps an accelerated aging process. In concert with clinicians, researchers, and polio survivors, PHI began to publish material on these “late effects of poliomyelitis,”. And in 1981 PHI convened the first of its international post-polio conferences to address this issue.
There have now been nine international PHI conferences on post-polio syndrome and other topics having to do with living and aging with polio. These “St. Louis conferences” as they are often called in polio circles, are not always held in St. Louis. The first in the series was held in Chicago, and the tenth was held in Warm Springs, Georgia, in 2009.
During the 1980s, as support groups for polio survivors began to form throughout the US and elsewhere, PHI offered help to such groups in various ways – especially through its conferences and publications (including directories of support groups and health care professionals), but also through arranging speakers, assisting with local or regional conferences, and sponsoring workshops. PHI is not itself a support group, but rather remains a network in support of such groups, and in support of individual polio survivors, clinicians, and researchers.
Until 1984, though always incorporated as a nonprofit organization, PHI had operated entirely with a large network of volunteers, organized and led by Gini Laurie. Financial support came from donors and subscribers to the Rehabilitation Gazette. But after the 1983 St. Louis conference, it was evident that a more formal organizational structure was required. Judith Raymond was hired as executive director in 1984, and took over PHI’s day-to-day operations as well as editorial work on its publications and organizational work on its conferences. She was succeeded in 1987 by Joan L. Headley, who served as executive director for 30 years, retiring in 2017. She was succeeded by Brian M. Tiburzi on September 1, 2017.
Poliomyelitis, commonly shortened to polio, is an infectious disease caused by the poliovirus. In about 0.5 percent of cases, it moves from the gut to affect the central nervous system and there is muscle weakness resulting in a flaccid paralysis. This can occur over a few hours to a few days. The weakness most often involves the legs, but may less commonly involve the muscles of the head, neck and diaphragm. Many people fully recover. In those with muscle weakness, about 2 to 5 percent of children and 15 to 30 percent of adults die. Up to 70 percent of those infected have no symptoms. Another 25 percent of people have minor symptoms such as fever and a sore throat, and up to 5 percent have headache, neck stiffness and pains in the arms and legs. These people are usually back to normal within one or two weeks. Years after recovery, post-polio syndrome may occur, with a slow development of muscle weakness similar to that which the person had during the initial infection.
Polio vaccines are vaccines used to prevent poliomyelitis (polio). Two types are used: an inactivated poliovirus given by injection (IPV) and a weakened poliovirus given by mouth (OPV). The World Health Organization (WHO) recommends all children be fully vaccinated against polio. The two vaccines have eliminated polio from most of the world, and reduced the number of cases reported each year from an estimated 350,000 in 1988 to 33 in 2018.
An iron lung, also known as a tank ventilator or Drinker tank, is a type of negative pressure ventilator (NPV); a mechanical respirator which encloses most of a person's body, and varies the air pressure in the enclosed space, to stimulate breathing. It assists breathing when muscle control is lost, or the work of breathing exceeds the person's ability. Need for this treatment may result from diseases including polio and botulism and certain poisons.
Post-polio syndrome is a group of latent symptoms of poliomyelitis (polio), occurring at about a 25 to 40% rate. These symptoms are caused by the damaging effects of the viral infection on the nervous system. Symptoms typically occur 15 to 30 years after an initial acute paralytic attack. Symptoms include decreasing muscular function or acute weakness with pain and fatigue. The same symptoms may also occur years after a nonparalytic polio (NPP) infection.
Ontario March of Dimes is a charitable organization which provides programs and services to people of all ages with physical disabilities in Ontario, Canada. Its headquarters is in Toronto. It is not affiliated with the American organization called March of Dimes.
Peer support occurs when people provide knowledge, experience, emotional, social or practical help to each other. It commonly refers to an initiative consisting of trained supporters, and can take a number of forms such as peer mentoring, reflective listening, or counseling. Peer support is also used to refer to initiatives where colleagues, members of self-help organizations and others meet, in person or online, as equals to give each other connection and support on a reciprocal basis.
The paralytic illness of Franklin D. Roosevelt (1882–1945) began in 1921 when the future President of the United States was 39 years old. His main symptoms were fever; symmetric, ascending paralysis; facial paralysis; bowel and bladder dysfunction; numbness and hyperesthesia; and a descending pattern of recovery. Roosevelt was left permanently paralyzed from the waist down. He was diagnosed with poliomyelitis at the time, but his symptoms are more consistent with Guillain–Barré syndrome (GBS) – an autoimmune neuropathy that Roosevelt's doctors failed to consider as a diagnostic possibility. In 1926, his belief in the benefits of hydrotherapy led him to found a rehabilitation center at Warm Springs, Georgia. He avoided being seen using his wheelchair in public, but his disability was well known and became a major part of his image. In 1938, he founded the National Foundation for Infantile Paralysis, leading to the development of polio vaccines.
The American Coalition of Citizens with Disabilities (ACCD) was, in the mid-1970s to early 1980s, a national consumer-led disability rights organization called, by nationally syndicated columnist Jack Anderson and others, “the handicapped lobby”. Created, governed, and administered by individuals with disabilities – which made it a novelty at the time—ACCD rose to prominence in 1977 when it mounted a successful 10-city “sit in” to force the federal government to issue long-overdue rules to carry out Section 504, the world's first disability civil rights provisions. ACCD also earned a place of honor in the disability rights movement when it helped to secure federal funding for what is now a national network of 600 independent living centers and helped to pave the way for accessible Public Transit in the U.S. After a brief and often tumultuous history, ACCD closed its doors in 1983.
Psychiatric rehabilitation, also known as psych social rehabilitation, and sometimes simplified to psych rehab by providers, is the process of restoration of community functioning and well-being of an individual diagnosed in mental health or emotional disorder and who may be considered to have a psychiatric disability.
The history of polio (poliomyelitis) infections began during prehistory. Although major polio epidemics were unknown before the 20th century, the disease has caused paralysis and death for much of human history. Over millennia, polio survived quietly as an endemic pathogen until the 1900s when major epidemics began to occur in Europe. Soon after, widespread epidemics appeared in the United States. By 1910, frequent epidemics became regular events throughout the developed world primarily in cities during the summer months. At its peak in the 1940s and 1950s, polio would paralyze or kill over half a million people worldwide every year.
The International Ventilator Users Network (IVUN) is a nonprofit network of mechanical ventilation users, respiratory health professionals, and ventilatory equipment manufacturers. Its focus is on the health and independent living of ventilator users, whether they are using assisted ventilation long-term – at home or in nursing facilities—or short-term in emergency rooms and critical care units.
Virginia Grace Wilson "Gini" Laurie was a central figure in the 20th century development, in the United States, of the independent living movement for people with disabilities. It is sometimes said that she was one of its two "grandmothers"—the other one being Mary Switzer, who was in charge of vocational rehabilitation at the national level from 1950 to 1970.
Judi Chamberlin was an American activist, leader, organizer, public speaker and educator in the psychiatric survivors movement. Her political activism followed her involuntary confinement in a psychiatric facility in the 1960s. She was the author of On Our Own: Patient-Controlled Alternatives to the Mental Health System, which is a foundational text in the Mad Pride movement.
TIRR Memorial Hermann is a 134-bed rehabilitation hospital, rehabilitation and research center, outpatient medical clinic and network of outpatient rehabilitation centers in Houston, Texas that offers physical rehabilitation to patients following traumatic brain or spinal injury or to those suffering from neurologic illnesses. In 2014, U.S. News & World Report named TIRR Memorial Hermann to the list of America's Best Hospitals for the 25th consecutive time.
The American Congress of Rehabilitation Medicine (ACRM) is an organization of rehabilitation professionals dedicated to serving people with disabling conditions by supporting research that promotes health, independence, productivity, and quality of life; and meets the needs of rehabilitation clinicians and people with disabilities.
Pakistan is one of the two remaining countries in the world where poliomyelitis (polio) is still categorized as an endemic viral infection, the other one being Afghanistan. As of 8 March 2021, there have been 1 documented cases in Pakistan in 2021, and 84 documented cases in Pakistan in 2020. The total count of wild poliovirus cases in Pakistan in 2019 was 147.
The Rehab Group, originally established in 1949 as the Rehabilitation Institute to provide training services to people with tuberculosis, is an international not-for-profit organisation providing health and social care, training and education, rehabilitation, employment and commercial services.
COPE Foundation is a not-for-profit voluntary organisation, formed on 29 May 1957. COPE supports approximately 2,150 children and adults with intellectual disabilities and/or autism throughout Cork city and county in Ireland.
Marilyn E. Saviola was an American disability rights activist, executive director of the Center for the Independence of the Disabled in New York from 1983 to 1999, and vice president of Independence Care System after 2000. Saviola, a polio survivor from Manhattan, New York, is known nationally within the disability rights movement for her advocacy for people with disabilities and had accepted many awards and honors for her work.