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• The challenge of spinal cord injury in Post-earthquake Nepal
  Kumar Paudel
  Published on: 2 September 2016

• Published on: 2 September 2016

  The challenge of spinal cord injury in Post-earthquake Nepal

  • Kumar Paudel, Medical Doctor
  • Other Contributors:
    • Samaj Adhikari

  On 25 April 2015 Nepal witnessed a huge earthquake of 7.8 magnitude claiming over 8000 lives and injuring more than 23,000[1].Those injured incurred either crush injuries, fractures or head and spinal cord trauma. WHO estimates,over 400 people have sustained spinal cord injuries owing to earthquake.[2]. They have become either paralyzed or developed weakness of limbs (paraparesis) extending from neck downward (quadriparesi...

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  On 25 April 2015 Nepal witnessed a huge earthquake of 7.8 magnitude claiming over 8000 lives and injuring more than 23,000[1].Those injured incurred either crush injuries, fractures or head and spinal cord trauma. WHO estimates,over 400 people have sustained spinal cord injuries owing to earthquake.[2]. They have become either paralyzed or developed weakness of limbs (paraparesis) extending from neck downward (quadriparesis) or in lower limbs (paraparesis) with bladder and bowel dysfunction. While many sustained primary injuries due to earthquake, many others sustained secondary injuries due to improper transportation of these patients to health facilities. Much of the reachable health facilities were damaged by earthquake and thus patients needing immediate spinal support were further deteriorated by this situation. In addition, majority of the health care providers involved in the search ,rescue and the evacuation were unaware of the concept of correct immobilization, log roll and transport technique. The use of the spinal board was hardly seen. This resulted in the neurological and vertebral damage further worsening to complete SCI(Spinal Cord Injuries). Spinal cord injury has a devastating effect in a person's life ranging from psychosocial impact to the different grades of disability. The challenges posed by spinal cord injuries vary in wide spectrum, particularly treatment of which demands clinician's technical expertise and advanced surgical facilities. Even in an advanced technical facility, treatment requires a concentrated effort and dedication of both the clinicians and the patients. With the good medical, nursing and physiotherapy most of the cases can be revived back to the normal. In Nepal, the only rehabilitation center, situated in Kavre district has received 150 patients with spinal injuries during the period of April to August 2015.There might have been several other cases of spinal cord injuries which might have been undocumented. Many undocumented cases might have been either unable to reach health center particularly, spinal cord- treating centres or might have given up hopes. This suggests the need of spinal injury treatment centres and inadequacy of current level of health facilities. Incomplete quadriplegia has good recovery while complete have bad prognosis. In Saga Spinal cord injury treatment center, among the treated cases, no death has been reported so far, however, the complications like Pressure sore has been reported in 16 patients. Impairment of autonomous dysfunction such as Urinary Treatment Centre has been reported in 50 patients and DVT (Deep Venous Thrombosis) in 6 patients. Out of the total 150 cases managed in this spinal cord treatment center, 50% underwent surgery for unstable fracture of spine while remaining were managed conservatively. In Nepal there are 20 spinal surgeons, 12 physiotherapists and 6 occupational therapists. These professionals are overburdened by current level of work. This necessitates the immediate need of further technical human resources.

  References: 1. Nepal, G.o., Post Disaster Needs Assessment. 2015: Nepal. 2. WHO, WHO mobilizes funds for long-term spinal cord treatment after Nepal earthquake. 2015: Nepal.

  Conflict of Interest:

  None declared

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  Conflict of Interest:
  None declared.

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