Spinal Cord Injury in Uganda

A spinal cord injury (SCI) is trauma to any part of the spina column that results in damage and alteration of function of the nerves of the spinal cord.

The spinal column has in its center nerves that control movement and sensation. Damage to any part of the spinal column can result in anything from partial loss of movement or sensation, to a complete loss of movement and sensation to all the nerves below the point of the injury. An injury can occur anywhere on the spinal cord.

The outcome of the injury can be anything from temporary to permanent quadriplegia (also known as tetraplegia) from a neck injury, to paraplegia for lower injuries. 

Complications of an SCI include:

Muscle atrophy
Pressure sores
Infections
Incontinence of bladder
Incontinence of the bowels
Breathing problems 

The global map for traumatic spinal cord injury epidemiology: update 2011, global incidence rate estimates that in East Africa the incidence of SCI is 21 per million every year. For an estimated 2016 population of 37,782,971 that means that approximately 793 people will have a traumatic SCI in Uganda this year.

The report International Perspectives on Spinal Cord Injury estimates that around two thirds of SCIs (64%) are caused by transport accidents. A report Prevalence and presentation of spinal injury in patients with major trauma admitted in Mulago hospital concludes:

The prevalence of spinal injury in patients with major trauma admitted in Mulago Hospital is 8.8% thus a serious problem. More than 50% of the respondents had neurological injury and Frankel’s score A. (Note: a Frankel score of A indicates a complete injury with no motor or sensory function below level of injury).

The report's conclusion continues, SCI's

are found in the most economically productive age group of 20 to 40 years therefore a big socioeconomic burden to the nation. There should be measures instituted by the policy makers to prevent spinal injury and the hospital should be fully equipped to manage spinal injury patients before they go back into the community.
Road safety measures should be enforced by the Police, Ministry of works and transport, so as to prevent road traffic injuries.

Importantly:

A Spinal rehabilitation center should be set up for patients with spinal injury in Mulago hospital, both in terms of infrastructure and trained personnel.

The Spinal Injuries Association in Uganda does valuable work. This posting from their Facebook page of 14th February 2014 shows that even among fellow persons with disabilities PWDs) people with SCIs feel marginalized.

There is little doubt that SCI is a disability like any other disability with its own feelings of stgmatization and prejudice.

Henry Nyombi is the Chairperson for the National Union of Disabled Persons of Uganda (NUDIPU) and has an SCI

The Uganda Spine Surgery Mission does valuable work throughout Uganda.

There are few resources for people with SCIs in Uganda, see Spinal Cord Injury Resources in UGANDA for some useful information.