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14th March 1999

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Give them the right wheels and therapy not pity

'Motivation', a British NGO working at the Ragama Rheumatology and Rehabilitation Hospital helps those suffering from spinal cord injury

By Udena Attygalle

Disability is not inability

The following figures hit you with astro-nomical force. Of the approximately15,000 opproximately cases of spinal cord injury recorded each year in Sri Lanka, only about 125 can be accommodated at Sri Lanka's only rehabilitation centre for such patients at Ragama.

Of the rest, most die,due to various complications and lack of proper understanding.

'Motivation' a British government-funded NGO which came to Sri Lanka in November 1997 is working with the Ragama Rheumatology and Rehabilitation Hospital to change these statistics, says Richard FrostRichard Frost, the project coordinator.

Two people who were instrumental in bringing down this group were Joe Jayaratne and Ingrid MacAlpine. The team consists of eight expatriates and 15 Sri Lankans who will be trained with the objective of carrying out the work after 'Motivation' leaves.

Injury at a lower level of the spinal cord may cause paralysis of the lower body while a neck injury could result in the victim losing control over even his upper body. Moreover a wheel-chair-bound life brings about many complications. Sores can occur in the upper legs and some blood vessels being compressed for too long a time can ultimately cause death. Losing control over internal organs like the bladder means that there is a high risk of infection.

Most of these injuries are brought about by the spinal cord snapping due to the impact caused by a fall from a height or due to road accidents, the latter being common in urban areas and the former in more rural areas, where climbing trees for reasons like toddy tapping is common. The victims are almost always young adult males, the sole bread winners of their families.

Nursing is the first step in the treatment. This is followed by physiotherapy and occupational therapy. The 'Motivation' team hopes to upgrade these services at the Ragama hospital. "Improving hygiene aspects, better infection control and an overhaul of out-dated methods are among the things that we have worked on," Frost said. The next step is the most important and the most frustrating. The patient returning home brings into focus many hitherto hidden problems, both social and economic. Dealing with these hurdles requires not only courage but also certain skills and equipment. The outrage team a part of 'Motivation', helps patients to identify and overcome specific problems that they would have to face.

A man in a wheelchair is, according to society at large, an object to be pitied, a person who cannot, and never will be able to fend for himself.

Observing the patients at the hospital we were left with only one conclusion. The social stigma was but a myth. Most patients who had gone through the right treatment and had the right equipment needed little help .

The most important 'right' equipment is the wheelchair. Unfortunately the wheelchairs commonly found in this country are not suited to local conditions.

By providing wheelchairs tailormade for Sri Lankan conditions using local raw materials, 'Motivation' hopes to rectify the situation. At a small work shop within the hospital premises, wheelchairs are assembled mostly by the handicapped,who are employed by the hospital.

Says Frost, "We hope to encourage the handicapped patients at the hospital to get involved in this project." They are being trained by Motivation with the hope that they would pass on their knowledge to others.

The range of wheelchairs include a 3 -wheel one designed for rough ground. This is the most popular, as most victims are from the rural areas where there are no smooth cemented floors in houses. The sports wheelchair is made so that playing wheelchair sports would be comfortable and easy. There are also wheel chairs made specially for children.

A tricycle attachment we sawconverted a normal wheel chair into a vehicle that could be used for long distance travel and over very rough terrain.

"The cushions made by Motivation are contoured, so that sores do not occur," Frost said.At present only about 20 wheelchairs are being made per month. These are distributed through the hospital, and the production will eventually be completely handed over to the hospital itself.

All these activities are designed to speed up the recovery of patients so that they could leave the hospital and some other patient could take their place.

"We hope that our work would help establish rehabilitation hospitals in other areas of the country," Frost said.

Disability is not inability

Priyantha Peris, a patient at the hospital, was a student at the "Lumumba" university in Russia. He was forced to leap from a 5 storey building, when it caught fire. His spinal cord was badly damaged in the fall.

Today he is the chief organizer of the Spinal Cord Injuries Society of Sri Lanka, an organization that aims to help patients rebuild their lives. Considering that most patients do not come back for follow- up treatment, due to economic restraints, their services could prove invaluable.

The society is based at the Ragama hospital.

All these activities give tremendous selfconfidence to the patients and prove not only to them but also to the "ablebodied", as Pryantha put it that, "disability is not inability".

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