Spinal Cord Injury
Besides physical and psychological rehabilitation, persons with SCI also need economic independence to lead a dignified life.
It is difficult to hazard a guess on the number of people that exist in India with Spinal Cord Injuries (SCI). However, it could well be somewhere between the Chinese figures of 65 cases per million and the US figures of 35 cases per million. Even if one takes a conservative figure of 40 cases per million, it would still leave us with a sizable 40,000 cases of SCI in India. Yet, SCI is a little acknowledged disability. While it may draw some medical attention; there is scarcely anything offered in terms of comprehensive physio-socio-economic rehabilitation from the government.
SCI is defined as damage or trauma to the spinal cord. This results in a loss or impairment of mobility and sensation. Common causes of damage to the spinal cord are trauma, brought on by accidents — vehicular or alcohol/drug induced, fall from heights, sports related, etc. It can also be caused by diseases such as polio, spina bifida, transverse myelitis and others. A larger number of men suffer from SCI, as they are more exposed to hazardous occupations at construction sites, painting buildings, etc.
Damage to the spinal cord is known as a lesion, and the paralysis is known as quadriplegia or tetraplegia if the injury is in the cervical region or as paraplegia if the injury is in the thoracic, lumbar or sacral region. There are two types of lesions associated with a spinal cord injury; these are known as complete and incomplete injuries. A complete injury means the person is completely paralysed below their lesion. Whereas an incomplete injury, means only part of the spinal cord is damaged.
There are five degrees of disability for those with an incomplete spinal injury, A: complete paralysis, B: sensory function only below the injury level, C: incomplete motor function below injury level, D: fair to good motor function below injury level, E: normal function.
The effects of a SCI manifest themselves in different ways, like reduced ability to regulate heart rate, blood pressure and sweating, loss of upper and lower limb functioning, loss of ability to feel pain and thermal sensation, loss of sexual functioning, loss of bowel and bladder control, spasticity, neuropathic pain, atrophy of muscles, osteoporosis and bone degeneration, gallbladder and renal stones besides others.
Rehabilitation after spinal injury requires a great deal of support and patience, and involves a sizable team of professionals like a neurologist, rehabilitation specialist, physical therapist, occupational therapist, respiratory therapist, social worker, speech therapist, nutritionist, special education teacher, recreation therapist and clinical psychologist.
Post injury, persons with SCI need an extremely supportive and positive environment, besides immediate counseling to come to terms with their injury and to begin the process of recouping. Depending on the severity of the injury, they will also need months of intensive and expensive medical attention. Unfortunately, there is no welfare scheme, that allows people with a SCI to meet the cost of months of hospitalization and specialized care. A person with a SCI will need to re-learn the functioning of his body and be sensitive to signs of urinary infection and pressure sores. A person with SCI will also need immediate physiotherapy to prevent contractures and gain as much mobility as possible. Importantly, they require economic rehabilitation to allow them to live an independent life.
The above article was published in the Bangalore edition of Deccan Herald on the 13th of March 2008 – http://www.deccanherald.com/Content/Mar132008/panorama2008031257023.asp