The techniques used by thetraditional physiotherapist (so-called traumatolegs traditionels) are described and the effectiveness of the methodology is analysed in order to determine the degree of appropriateness of the integration of these techniques in the institutional health system of Mali.

The large presence of traditional physiotherapists in all the communities, places them in health agents that cover the whole geography of the study area. In addition to the high degree of symbolic efficacy, the physical techniques used do not differ substantially from those used by Western physiotherapists, in addition to the greater economic, geographical and temporal accessibility than the resources directed by the biomedical system to disability..

A record of the clinical course of 67 patients, affected by fractures, sprains and dislocations, was made.

Participant observation was conducted describing the techniques used by traditional physiotherapist in Bamako (Mali),  evaluating the evolution and final state of different variables indicating functionality, pain, passive mobility, swelling, state of gait and wound condition.

Results.

As a result, it was found that the techniques used by traditional physiotherapists follow the same principles as biomedical physiotherapy and that the evolution of the patients was highly satisfactory in more than 60% of cases in all the variables studied.

Conclusions.

The biomedical analysis of the manual therapy techniques used, together with the results of the case follow-up and the accessibility of the care provided by these professionals, are indicative of the high level of suitability of the integration of traditional physiotherapy into the institutional health system.

These results lead us to propose the collaboration of both professionals, biomedical and traditional physiotherapists, always with the patient as the centre, establishing agreed itineraries and enriching the practices of both with the knowledge acquired mutually.

To strengthen the physiotherapy attention and to promote the integration of the traditional "physiotherapy" in the assistance system, under the respect and understanding of both professionals, placing the patient in the centre and as an objective, with the intention that the care network directed to the disability is enriched with the knowledge and resources inherent to the systems integrating the medical pluralism present in these countries.

Keywords:

physiotherapy, traumatology, traditional, Mali, fracture, treatment, Africa.

Source of funding.

The stays in Mali were financed by the Cooperation and Development Unit of the University of Lledia through the annual call for cooperation projects and by the Spanish Agency for Cooperation and Development, which granted me a scholarship to carry out my doctoral research in Mali

Acknowledgments

My acknowledgments to the Office of Cooperation and Development as well as the Faculty of Nursing and Physiotherapy of the University of Lleida who have always believed in this project and have granted me all their support and my thesis director, Albert Roca, for his constant guidance and encouragement.

Non applicable