FOCUS- World Spinal Cord Injury Day: Let’s take the challenge one step higher! | September 5, 2020
On World Spinal Cord Injury Day, Erik Weerts (Emergency Rehabilitation Specialist at Humanity & Inclusion) explains how this injury can have serious long-term implications and how rehabilitation can make the difference for the persons who sustain it, families and communities. Read the article in French here. Rehabilitation improves individual functioning, independence, and quality of life. […]
On World Spinal Cord Injury Day, Erik Weerts (Emergency Rehabilitation Specialist at Humanity & Inclusion) explains how this injury can have serious long-term implications and how rehabilitation can make the difference for the persons who sustain it, families and communities.
Rehabilitation improves individual functioning, independence, and quality of life. However, rehabilitation services are often under-resourced, undeveloped, and unaffordable for the poorest and most marginalized populations. As a result, an extensive need for rehabilitation remains unmet, especially in low and middle-income countries.
The COVID-19 pandemic is showing health leaders worldwide the importance of strengthening health systems in order to be better respond to crises, but also to ensure that other services continue functioning in exceptional times. Rehabilitation cannot be forgotten, as it is essential for many persons, including those living with spinal cord injuries.
“Spinal cord injury is preventable, survivable and should not lead necessarily to poor health and quality of life. The challenge needs to be taken one step higher!”
Eric Weerts, Emergency Rehabilitation Specialist at Humanity & Inclusion
Hello Eric, thank you for your time. Let’s start from the basics: what is a spinal cord injury and what are its consequences?
Spinal cord injury is damage to the spinal cord that causes temporary or permanent changes in its function. It may affect in different ways mobility, sensation, bladder and bowel functions, and psychosocial status, with impact on the individual, family, and community. The severity of spinal cord injury’s consequences depends on a range of factors, including the age at which the injury occurs, the extent of the injury, the availability and timing of services for treatment, and the environment (including physical, social, economic and attitudinal factors) in which the person lives.
People with spinal cord injury are two to five times more likely to die prematurely. They also have lower rates of school enrollment and economic participation than other people.
How many people live with spinal cord injury? What are the leading causes?
Every year between 250 000 and 500 000 people suffer a spinal cord injury. Up to 90% of these cases are due to traumatic causes, such as road traffic crashes, falls or violence. There is also a surging trend of Spinal Cord Injuries from non-traumatic causes (diseases, congenital issues).
How does rehabilitation assist persons living with spinal cord injuries?
Spinal Cord Injury has for long time been associated with very high mortality rates. However, today we know that Spinal Cord Injury is preventable, survivable and does not preclude good health and social inclusion.
Improved emergency response, effective health and rehabilitation interventions, assistive technologies (such as respirators, appropriate wheelchairs , assistive products for daily activities), social support, and accessible environments can help people with spinal cord injury live longer and more independently, and participate in society.
What are the challenges in low and middle income countries to support sustaining spinal cord injuries?
As there is yet no cure available to repair Spinal Cord Injuries, the combination of emergency response, physical rehabilitation and psychosocial life adjustments is the best proven strategy for persons living with Spinal Cord Injuries.
However, limited availability of emergency and rehabilitation services, lack of professional workforce, and financial barriers represent important challenges in low and middle income countries hindering people’s access to care after injury. In settings with limited resources, training of caregivers to support the persons with spinal cord injuries, economic empowerment of people living with spinal cord injuries and their family members, and culturally -appropriate inclusion strategies have shown good results.
Showing that rehabilitation strategies are cost-effective and allow people with spinal cord injuries to survive and thrive can be a stimulus for health decision-makers to develop adequately-resourced services.
What role can NGOs play in regards to spinal cord injuries care? What has HI done?
NGOs have always played an important role in both complementing existing care systems and empowering people living with spinal cord injuries to foster their participation in society. NGOs like Humanity & Inclusion and international networks like the International Spinal Cord Society have been key players in the formulation and implementation of basic standards, protocols, and pathways of care for spinal cord injuries in challenging settings.
The first Humanity & Inclusion’s project on spinal cord injuries’ care took place in refugee camps on the Thai- Cambodian border in the late 1980s and led to the development of a regional care center, which is a reference until now. Across its projects in several countries, Humanity & Inclusion has supported national health systems to set-up spinal cord injuries centers; build the capacity of the rehabilitation workforce; and pilot new care methodologies. Over the years, HI has responded to the needs arisen during and in the aftermath of natural disasters, conflicts and chronic crises, in contexts where response to spinal cord injuries was not prioritized. For instance, the Syrian conflict has shown that the use of explosive weapons in populated areas is a leading cause of spinal cord injuries and also has devastating impact on the lives of people already living with spinal cord injuries or other impairments.
In your opinion, which actions should be prioritized for persons with spinal cord injuries, their families, and communities?
First of all, it is crucial to empower local stakeholders to tackle the weak links in the pathway of care for the patient. Actions taken locally are the most effective to build the capacity of the rehabilitation workforce, as well as to empower persons living with spinal cord injuries and their caregivers to become actors and solution providers within their communities.
Secondly, integrating spinal cord injury care in national rehabilitation strategies allows to plan for adequate resources based on the population’s needs, and in compliance with widely accepted standards of care. These resources should not only focus on emergency response and early treatment, but also integrate prevention of spinal cord injury and lifelong functional adjustments.