Ida Ismail
For thousands of patients diagnosed with multiple sclerosis, the daily battle is not only with the disease, but also with a healthcare system that does not serve them properly. Multiple sclerosis is a chronic autoimmune disease that mainly affects people aged 20-40 and damages the nervous system, causing vision problems, difficulty in movement and even disability over the years. Drug therapies can slow the progression of the disease, but they are not enough without physiotherapy, a vital service that in Albania is almost completely absent from the public system.
A 38-year-old patient from Tirana who has been dealing with multiple sclerosis for years says that there is a lack of physiotherapy at the state hospital, making it impossible to receive this service.
Patient EV says: "My doctor recommends physiotherapy, but the public hospital doesn't offer it. The only option is private, but I can't afford the cost. The lack of physiotherapy has caused me to lose strength in my legs much faster."
Even Tanush Çaushi, diagnosed with Multiple Sclerosis for more than 10 years, says that the public health system does not provide free physiotherapy, as claimed. Çaushi said: "Physiotherapy for people with multiple sclerosis is not a luxury, but it is vital. I have to do 3 sessions a week at 25-30 euros per session, not counting transportation. The costs are unaffordable."
Unfulfilled promises
Worldwide, 2.8 million people are affected by multiple sclerosis. In Albania, there are 35 patients with multiple sclerosis per 100 inhabitants. However, the fact that there is no national registry with data on registered patients receiving treatment remains a concern.
According to QSUT statistics, there are about 1000 patients, while studies by the “Tree of Life” Foundation show that there are about 2000 patients suffering from multiple sclerosis. One of their most vital needs is physiotherapy, a service that is almost completely lacking in the country's health centers. Neurologists emphasize that rehabilitation exercises and regular therapies help slow down the progression of the disease.
Head of Neurology Dr. Jera Kruja said: "I have tried to create an appropriate environment with a gym, but it does not depend on neurology. The physiotherapy service is important not only in the hospital, but also very important in the outpatient setting."
In 2023, the Minister of Health announced that physiotherapy Services would be expanded to 17 health centers with 34 new professionals, physiotherapists and speech therapists, mainly in the Tirana and Durrës regions. At that time, the Minister promised that patients with a neurologist’s recommendation would receive physiotherapy Services in health centers, but the reality is completely different. There is a lack of physiotherapists, some of the centers are located on high floors, without elevators or ramps, making it impossible for patients with mobility difficulties to receive the service.
Tanush Çaushi, who uses a walker, says: "Physiotherapy is only offered in two of them, Health Center No. 6 and Health Center No. 10, but even there with minimal staff and inadequate space. In most centers, patients face a lack of infrastructure and conditions, forcing them to go to private clinics."
Legal aspect: Paper Services, lack of implementation
The 2016 Law “On Social Care Services” obliges the state to provide rehabilitation Services in the community. However, in practice, these Services do not exist.
Dorjan Konomi, from the Anti-Discrimination Commission, says it clearly: "The law exists, but the problem remains implementation. We pay taxes, but we do not receive the Services we are entitled to. We are not asking for alms, but the legal right to quality Services."
Multiple sclerosis is often called the disease with 1.000 faces, as patients suffering from this disease have a variety of symptoms, which can affect almost every part of the body and mind. Although multiple sclerosis is an incurable disease, it is important to start adequate treatment, therapy as soon as possible, as this significantly reduces disease activity and the progression of disability.
On average, 7 months after diagnosis, patients and their family members are forced to make work-related changes. The number of people with multiple sclerosis who are able to work is rapidly decreasing, as the rate of disability increases.
Psychologist Marsida Simo said: "Over 60% of patients lose their jobs within 10 years of diagnosis, increasing the burden on families and the state. The benefits to the state would be greater if these people were treated, as they could work and contribute to the economy."
Multiple sclerosis can lead to significant economic losses to society. The unemployment rate among people with multiple sclerosis is higher than that of the general population.
Multiple sclerosis in Albania remains a disease underestimated by institutions. The lack of physiotherapy for these patients is not simply a gap in the health system, but an injustice that weighs on them every day. On paper, there are strategies, plans and promises. But the reality is bitter: Patients do not receive service and pay dearly for care that legally should be free.
