The challenge of spinal cord injury care in the developing world

Abstract

Great strides have been made in reducing morbidity and mortality following spinal cord injury (SCI), and improving long-term health and community participation; however, this progress has not been uniform across the globe. This review highlights differences in global epidemiology of SCI and the ongoing challenges in meeting the needs of individuals with SCI in the developing world, including post-disaster. Significant disparities persist, with life expectancies of 2 years or less not uncommon for persons living with paraplegia in many developing countries. The international community has an important role in improving access to appropriate care following SCI worldwide.

Figure 1

Hand-cycle wheelchair in Mozambique. A young man with paraplegia had to stop attending school after the chain in the arm cycle broke, and replacement parts were unavailable.

Figure 2

Hilly terrain in a wheelchair inaccessible community in Port-au-Prince, Haiti. Courtesy of Fiona Stephenson.