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Treating The Spinally Injured After Nepal Earthquakes

May 28, 2015

The recent earthquakes in Nepal have left an estimated 400 people with serious spinal cord injuries. Many of them are presently being treated at the country’s only spinal injury rehabilitation centre. Stephen Muldoon of the British charity Livability describes the situation on the ground.

On 25 April the first devastating earthquake struck Nepal causing 8,500 deaths, 16,000 injuries and 300,000 homes were destroyed. Nearly three weeks later I witnessed a second quake which caused another 141 fatalities and 3,000 injuries. Another significant statistic is that there have already been more than 173 spinal injuries resulting from the earthquakes. This number is predicted to rise to 400.

Infrastructure and remoteness are just two reasons for these numbers, along with the sheer power of the earthquake – the first quake registered at 7.8 on the Richter scale (in comparison, the 2010 Haiti quake measured 7.0). Many buildings in Nepal are not built to withstand powerful tremors and will collapse more readily, leaving people beneath. Spinal cord injuries need immediate care, and problems mount when people are stuck in inaccessible or remote areas.

Even without earthquakes, those with spinal cord injuries in Nepal can have a difficult time adjusting. Situated on the cusp of one of the greatest mountain ranges in the world, the country’s terrain is not particularly forgiving for those with mobility issues – let alone wheelchair users. Culturally, the belief prevails that disability is somehow a punishment, making it difficult for newly-disabled people to fully reintegrate into society.

I work for Livability, a UK disability charity partnered with the Spinal Injury Rehabilitation Centre (SIRC), the only centre of its kind in Nepal. Based in Sanga near the capital Kathmandu, it is currently under more pressure than ever before.

I’ve seen first-hand what they have to face. When the second earthquake struck I witnessed the noise and screams of the centre’s patients. I felt the building shake and saw terrified people, already injured, being moved outside and sheltered under tarpaulin by the courageous staff.

The building withstood the quakes, but some patients were still, quite understandably, too afraid to return inside. The staff then faced a second problem – how to hydrate and keep cool a ward’s worth of patients in the hot Nepal sun.

The centre’s normal maximum capacity is 50 beds – it’s currently more than double that figure, at 110 beds. The patients are in corridors and every other piece of available space.

They have been divided into three groups depending on the level of care they require. Each patient has a family member that stays with them and who receives training from nursing staff so they can give effective help. The centre also employs peer counsellors – people who already have spinal cord injuries – and support workers who provide rehab support.

It has been an exhausting time for staff in the oversubscribed centre yet each day they come in to work calmly and with a smile. They recently adopted a new slogan: “If we don’t do it who will? If we don’t do it now – when? If we do it, we will do it right.”

Kaami Lama, from the north east of Kathmandu, is one of the patients. On the day of the earthquake his house collapsed onto his back. Having sustained spinal fractures, Kaami was stuck beneath the rubble, unable to move or cry for help. Amazingly, he was rescued and airlifted to hospital in Kathmandu, and was then transferred to SIRC to stabilise the fracture and start his rehabilitation.

Kaami can transfer from bed to wheelchair and has begun to practice standing and walking. He can now move independently using a walking frame.

With a newly acquired life-changing disability it is perhaps hard to think of Kaami is one of the lucky ones but, as so many were killed, that’s what he considers himself to be. In his own words, he feels he has been gifted a “second life”.

When Kaami is discharged, he desperately wants to return to his village but is aware that many are now living in tents and makeshift shelters which are not ideal for a disabled person. Meanwhile, the June monsoon rains are lurking around the corner, set to wreak havoc to the insubstantial shelters and temporary shanties. The work is very much only begun.

For people like Kaami, beyond all these immediate challenges to recovery lies an even longer road to the regaining of independence and ability to live freely. Nepal has a long way to go in fully accommodating disabled people into its society, but organisations such as SIRC fill me with a bright ray of hope.

Stephen Muldoon is Livability’s Assistant Director of International and Complex Care Development. For information about their Nepal Urgent Rehabilitation Appeal click here

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